ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2019
Posterior condylar bone resection and femoral implant thickness vary by up to 3 mm across implant systems: implications for flexion gap balancing.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 6 citations in OpenAlex.
- Comparison of outcomes between gap balancing and measured resection techniques for total knee arthroplasty: A prospective, randomized, controlled trial.Acta orthopaedica et traumatologica turcica · 2021Trial
- Instrumented Mechanical Total Knee Arthroplasty Routinely Decreases the Medial Posterior Condylar Offset.Cureus · 2025Article
- Does the femoral component design modified in consideration of Asian anatomical characteristics fit better than the conventional design for Korean femora in reality?Archives of orthopaedic and trauma surgery · 2024Article
- Anatomical Reference of the Femur after Distal Resection Is Reliable for Rotational Alignment in Total Knee Arthroplasty.Journal of personalized medicine · 2024Article
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of this study was to evaluate the thickness of medial and lateral posterior femoral condylar bone resected with five implant systems using posterior referencing jigs set at 3° of external rotation. The hypothesis was that posterior condylar resection thickness on the medial side would be equal to the thickness of the femoral implant posteriorly, regardless of implant system.
methodsPosterior referencing femoral sizers were used on right femur sawbones models for five different implant systems. Each sawbones model was sized using a femoral sizer for the specific implant system. Sizing guides were set at 3° of external rotation for the right femur. Each system's 4-in-1 cutting block was then used to make posterior condylar cuts. The thicknesses of the cut bones were measured using a manual calliper.
resultsThe amount of bone resected from both medial (P = 0.0004) and lateral (P < 0.0001) posterior condyles differed significantly across the five implant systems. The mean thickness of bone resected from the posteromedial femoral condyle ranged from 9.4 ± 0.5 to 12.4 ± 0.9 mm. The mean thickness of the posterolateral condyle cut ranged from 6.7 ± 0.6 to 10.2 ± 0.3 mm. The difference in thicknesses between the bone resection from the posteromedial condyle and the implant thickness of the posterior condyles ranged from 0.6 to 2.9 mm.
conclusionsThe thickness of bone removed from the posterior femoral condyles varied by up to 3 mm across the five TKA implant systems. For each system, the posteromedial condyle resection was larger than the thickness of the posterior condyle of the actual implant. As the difference between the posterior bone resection and the implant thickness increases, the flexion gap will likely loosen and should be accounted for during gap balancing. In commonly used knee implant systems, resected bone is greater than implant thickness and may lead to flexion instability.
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