Profile of the distal femur anterior cortex--a computer-assisted cadaveric study

Abstract

Introduction: Accurate positioning and sizing of the femoral component in total knee arthroplasty is important for stability and functional outcome. The purpose of the study was to evaluate the bony profiles of the distal anterior femoral cortex (AFC).

Materials and methods: Anatomical bony landmarks on 50 adult cadaveric femora were collected. Critical points were used to identify the distal AFC surface.

Results: There were four anterior cortex profiles: (1) lateral side highest and medial side lowest (56%); (2) lowest height in median area (26%); (3) highest height in median area (14%); (4) medial side highest and lateral side lowest (4%).

Discussion: Anterior referencing in TKA needs to represent the anterior shape of the distal femoral cortex to prevent notching, femoro-patellar overstuffing or flexion gap mismanagement. Due to the variability of the AFC, surgeons have to carefully select the AFC landmark to be sure of avoiding complications.