title: The intercondylar notch ceiling: an accurate reference for distal femoral resection in total knee arthroplasty for severely degenerated varus knees.
abstract: OBJECTIVE
  To measure the distance from the intercondylar ceiling to the lowest point of the medial and lateral femoral condyles in a healthy population so to obtain a clearly discernible and accurate landmark for proper distal femoral resection during total knee arthroplasty (TKA).
  
  
  METHODS
  Three-dimensional models of the lower extremities of 100 healthy Chinese subjects were constructed using computed tomography scans. The distance between the distal surface of the medial femoral condyle and the intercondylar notch ceiling, in the direction of the femoral mechanical axis, was measured.
  
  
  RESULTS
  The mean distance from the distal surface of the medial femoral condyle to the intercondylar notch ceiling was 9.1 ± 1.4 and 8.2 ± 1.4 mm in male and female subjects, respectively. Interestingly, this distance did not differ significantly with varying sizes of the distal femur.
  
  
  CONCLUSIONS
  The intercondylar notch ceiling could be used as an accurate landmark to determine the proper distal femoral resection level during TKA. For the clinical relevance, the distal femoral bone cut should be at the level of the intercondylar notch ceiling when using the most of the current TKA prosthesis systems.
authors.affiliation: Shanghai Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Bing
authors.initials: B
authors.lastname: Yue
authors.affiliation: Shanghai Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
authors.affiliation: Shanghai Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China. drwangyou@163.com.|Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China. drwangyou@163.com.
authors.forename: You
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Shanghai Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Mengning
authors.initials: M
authors.lastname: Yan
authors.affiliation: Shanghai Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Shanghai Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Yiming
authors.initials: Y
authors.lastname: Zeng
mesh_terms: D000328:Adult; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D017760:Bone Malalignment / Q000517:prevention & control*; D002681:China; D004838:Epiphyses / Q000601:surgery; D005260:Female; D005269:Femur / Q000033:anatomy & histology* / Q000601:surgery*; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D007720:Knee Prosthesis; D035002:Lower Extremity / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology* / Q000601:surgery*; D014057:Tomography, X-Ray Computed
keywords: Anatomic landmark; Distal femoral resection; Intercondylar notch ceiling; Joint line; Total knee arthroplasty