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Reliability of the posterior condylar offset.

Vicente J León-Muñoz1, Andrea Parrinello2, Gianluca Galloni3

  • 1Department of Orthopedic Surgery and Traumatology, Hospital General Universitario Reina Sofía, Murcia, Spain.

Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society
|October 30, 2021
PubMed
Summary

Measuring posterior condylar offset (PCO) using standard X-rays may be unreliable. Femoral rotation for 2D imaging introduces errors, invalidating PCO measurements for total knee arthroplasty outcomes.

Keywords:
distal femurkneeposterior condylar offsetthree-dimensional assessmenttotal knee arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Radiology
  • Biomedical Engineering

Background:

  • The posterior condylar offset (PCO) is a proposed factor influencing range of motion after total knee arthroplasty.
  • Current consensus on PCO's role and accurate measurement techniques remains limited.

Purpose of the Study:

  • To evaluate the accuracy of 2D X-ray measurements for posterior condylar offset (PCO).
  • To quantify the error introduced by femoral rotation in standard lateral X-ray projections for PCO assessment.

Main Methods:

  • Compared PCO measurements from 50 true lateral X-rays with 3D computed tomography (CT) models.
  • Assessed PCO on both medial and lateral femoral condyles using 3D CT.
  • Analyzed the angular discrepancy between posterior femoral cortical and condylar axis planes on axial CT views.

Main Results:

  • Significant differences were found in PCO measurements between medial (25.8 ± 3.67 mm) and lateral (16.59 ± 2.92 mm) condyles on 3D CT.
  • 3D PCO values significantly differed from those obtained via radiographic studies.
  • A mean angular discrepancy of 11.23° ± 3.64° was identified between the posterior femoral cortical and condylar axis planes due to rotation.

Conclusions:

  • The rotation required to achieve overlapping condyles in 2D lateral X-rays introduces significant angular discrepancies.
  • These discrepancies invalidate the reliability of 2D X-ray assessments of posterior condylar offset (PCO).
  • 3D imaging provides more accurate and distinct PCO measurements for medial and lateral condyles.