Publication:

Influence of femoral posterior condylar offset on functional outcomes following posterior-stabilized fixed bearing total knee arthroplasty: a prospective observational study

Background Total knee arthroplasty (TKA) provides effective pain relief and functional improvement in advanced osteoarthritis; however, suboptimal postoperative knee flexion persists in some patients. Femoral posterior condylar offset (PCO) is an important determinant of femoral rollback, flexion gap balance and quadriceps efficiency, particularly in posterior-stabilised (PS) TKA. Evidence regarding its influence on functional outcomes remains inconsistent, with limited data from the Indian population.

Methods A prospective observational study was conducted in 21 patients aged 50–80 years with Kellgren–Lawrence grade 3 or 4 osteoarthritis undergoing posterior-stabilised, fixed-bearing primary TKA between April 2024 and September 2025. Preoperative and postoperative PCO and posterior condylar offset ratio (PCOR) were measured using true lateral radiographs. Functional outcomes were assessed using the Knee Society Score (KSS) at 6 weeks, 3 months and finally at 6 months. Statistical analysis evaluated the association between PCO changes and functional outcomes.

Results The mean age was 66.81±5.56 years. KSS showed significant improvement over time (p 2 mm had inferior outcomes (p<0.001).

Conclusions Preservation of femoral PCO is associated with improved functional outcomes following PS TKA. As a modifiable surgical parameter, accurate femoral sizing and posterior condylar resection are essential to optimise postoperative knee function.