Distal femoral rotational alignment in the Indian population – An important consideration in total knee arthroplasty

ObjectiveTo measure the angular relationships of distal femoral rotational axes in the normal Indian population.Materials and methodsMagnetic Resonance Imaging (MRI) scans of the knee of 40 Indian subjects were used to define the posterior condylar axis, the transepicondylar axis and the Whiteside's line (anteroposterior axis). The posterior condylar angle (PCA) – the angle between the posterior condylar axis and the transepicondylar axis, and the Whiteside-epicondylar angle (W-EP angle) were then calculated.ResultsThe mean posterior condylar angle in the Indian knee was 4.67° and the mean Whiteside-epicondylar angle was 92.7°.ConclusionThere are differences in the distal femoral rotational axes among various races. The mean PCA and the W-EP angle are more externally rotated in the Indian than in the Western, population, but similar to the Chinese. Using fixed values to define the angular relationships between the axes could lead to malrotation of the femoral component. An understanding of the racial differences is essential while designing implants for the Indian population.