An Anatomic Investigation Into the Relationship Between Posterior Condylar Offset and Posterior Tibial Slope of One Thousand One Hundred Thirty-Eight Cadaveric Knees

Abstract

Background: Posterior condylar offset (PCO) and posterior tibial slope (PTS) have critical consequences in total knee arthroplasty, especially with regards to sagittal plane balancing. However, there has only been limited investigation into the functional consequences of each, and there have only been anecdotal observations regarding any associations between PCO and PTS.

Methods: In a large osteological study of 1138 knees, standardized measurements of PCO and PTS were taken using previously described techniques on specimens of different age, race, and gender. Multiple linear regression was performed to determine the independent predictors of medial and lateral PTS.

Results: Mean standardized medial PCO was greater than lateral PCO (1.22 ± 0.16 vs 1.15 ± 0.19 mm, P < .001) and medial PTS was greater than lateral PTS (7.3 ± 3.8° vs 5.7 ± 3.7°, P < .001). Decreasing PCO, female gender, and African-American race were associated with both increased medial and lateral PTS. Neither age nor femoral length correlated with medial or lateral PTS.

Conclusion: These data are the first to quantify that an inverse correlation between PCO and PTS exists. This relationship represents an important area for future biomechanical and clinical studies.

Keywords: implant design; knee anatomy; posterior condylar offset; tibial slope; total knee arthroplasty.