Clinical anatomy of distal femur and its implications in total knee arthroplasty: a radiological study

Osteoarthritis (OA) of the knee is a chronic disease affecting joints and its tissues, leading to gradual damage of articular cartilage and surrounding synovial tissues. The treatment of choice in case of end-stage knee osteoarthritis, total knee arthroplasty (TKA) is currently one of the most commonly performed surgeries. However, in many cases, as high as 20% there may be dissatisfaction, due to inability to recreate the normal knee biomechanics. For that reason this study aimed to provide the most comprehensive morphometric data of distal femur, as well as their implications in TKA. The computer tomography (CT) of total 500 knees, randomly selected patients, without significant knee pathologies (i.e. severe osteoarthritis, traumatic injury, endoprosthesis) were included from 2023 to 2025 This morphometric data was imported and calculated in SPSS software and included intercondylar notch max height and transverse width, epicondylar width, medial and lateral condyle transverse width, femoral mediolateral and anteroposterior distal end dimension, as well as notch shape index. There was no statistically significant correlation between the side of the limb and the morphology of distal femur. On the other hand all obtained morphometric parameters in relation to sex and age were found to have statistically significant correlations. Clinicians, especially orthopedic surgeons must understand the complex anatomy of the distal femur. It can provide crucial information during total knee arthroplasty(TKA) and especially during the positioning of the intramedullary alignment rod.