Native femoral geometry reveals consistent distal and posterior offsets with variable anterior compartment: a morphometric analysis

A recent study examined the geometric relationship between the compartments of the human femur, specifically focusing on the offsets between the anterior, distal, and posterior sections. Researchers analyzed computed tomography scans of 265 young, non-osteoarthritic knees, measuring parameters such as anterior central offset (ACO), anterior lateral offset (ALO), and distal medial offset (DMO) among others, relative to the surgical transepicondylar axis and normalized to epicondylar width.

The findings revealed that while there was no significant difference in offset parameters between men and women, the distal and posterior femoral condyles formed a geometrically coherent unit that could be approximated using a single radius. Conversely, the anterior compartment demonstrated a strong correlation with its own offsets but a significantly weaker connection to the flexion arc, suggesting that patient-specific, asymmetric implant systems may be more effective in restoring the native femoral geometry than the current off-the-shelf designs.