title: Posterior condylar offset does not correlate with knee flexion after TKA.
abstract: BACKGROUND
  Studies of medial and lateral femoral posterior condylar offset have disagreed on whether posterior condylar offset affects maximum knee flexion angle after TKA.
  
  
  OBJECTIVE
  We asked whether posterior condylar offset was correlated with knee flexion angle 1 year after surgery in (1) a PCL-retaining meniscal-bearing TKA implant, or in (2) a PCL-substituting mobile-bearing TKA implant.
  
  
  METHODS
  Knee flexion angle was examined preoperatively and 12 months postoperatively in 170 patients who underwent primary TKAs to clarify the effect of PCL-retaining (85 knees) and PCL-substituting (85 knees) prostheses on knee flexion angle. A quasirandomized design was used; patients were assigned to receive one or the other implant using chart numbers. A quantitative three-dimensional technique with CT was used to examine individual changes in medial and lateral posterior condylar offsets.
  
  
  RESULTS
  In PCL-retaining meniscal-bearing knees, there were no significant correlations between posterior condylar offset and knee flexion at 1 year. In these knees, the mean (± SD) postoperative differences in medial and lateral posterior condylar offsets were 0.0 ± 3.6 mm and 3.8 ± 3.6 mm, respectively. The postoperative change in maximum knee flexion angle was -5° ± 15°. In PCL-substituting rotating-platform knees, similarly, there were no significant correlations between posterior condylar offset and knee flexion 1 year after surgery. In these knees, the mean postoperative differences in medial and lateral posterior condylar offsets were -0.5 ± 3.3 mm and 3.3 ± 4.2 mm, respectively. The postoperative change in maximum knee flexion angle was -2° ± 18°.
  
  
  CONCLUSIONS
  Differences in individual posterior condylar offset with current PCL-retaining or PCL-substituting prostheses did not correlate with changes in knee flexion 1 year after TKA. We should recognize that correctly identifying which condyle affects the results of the TKA may be difficult with conventional radiographic techniques.
authors.affiliation: Ishii Orthopaedic & Rehabilitation Clinic, 1089 Shimo-Oshi, Gyoda, Saitama, 361-0037, Japan. ishii@sakitama.or.jp
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Ishii
authors.forename: Hideo
authors.initials: H
authors.lastname: Noguchi
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Takeda
authors.forename: Junko
authors.initials: J
authors.lastname: Sato
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Toyabe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee; D001696:Biomechanical Phenomena / Q000502:physiology; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016119:Posterior Cruciate Ligament / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D011184:Postoperative Period; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D016896:Treatment Outcome