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The Bone & Joint Journal

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The Journal of Bone & Joint Surgery British Volume
Vol. 84-B, Issue 1 | Pages 50 - 53
1 Jan 2002
Bellemans J Banks S Victor J Vandenneucker H Moemans A

Our purpose was to determine the mechanism which allows the maximum knee flexion in vivo after a posterior-cruciate-ligament (PCL)-retaining total knee arthroplasty.

Using three-dimensional computer-aided design videofluoroscopy of deep squatting in 29 patients, we determined that in 72% of knees, direct impingement of the tibial insert posteriorly against the back of the femur was the factor responsible for blocking further flexion.

In view of this finding we defined a new parameter termed the ‘posterior condylar offset’. In 150 consecutive arthroplasties of the knee, the magnitude of posterior condylar offset was found to correlate with the final range of flexion.