Analysis of Variation in Sagittal Curvature of the Femoral Condyles.

In designing femoral components, which restore native (i.e., healthy) knee kinematics, the flexion-extension (F-E) axis of the tibiofemoral joint should match that of the native knee. Because the F-E axis is governed by the curvature of the femoral condyles in the sagittal plane, the primary objective was to determine the variation in radii of curvature. Eleven high accuracy three-dimensional (3D) femur models were generated from ultrahigh resolution CT scans. The sagittal profile of each condyle was created. The radii of curvature at 15 deg increments of arc length were determined based on segment circles best-fit to ±15 deg of arc at each increment. Results were standardized to the radius of the best-fit overall circle to 15 deg-105 deg for the femoral condyle having a radius closest to the mean radius. Medial and lateral femoral condyles exhibited multiradius of curvature sagittal profiles where the radius decreased at 30 deg flexion by 10 mm and at 15 deg flexion by 8 mm, respectively. On either side of the decrease, radii of segment circles were relatively constant. Beyond the transition angles where the radii decreased, the anterior-posterior (A-P) positions of the centers of curvature varied 4.8 mm and 2.3 mm for the medial and lateral condyles, respectively. A two-radius of curvature profile approximates the radii of curvature of both native femoral condyles, but the transition angles differ with the transition angle of the medial femoral condyle occurring about 15 deg later in flexion. Owing to variation in A-P positions of centers of curvature, the F-E axis is not strictly fixed in the femur.