The Validity of Using the Posterior Condylar Line as a Rotational Reference for the Femur

Rotation of the femur is usually measured by the posterior condylar line (PCL). However, the functional position of the PCL has not been studied well. The angles between the PCL and the horizontal body line (HBL) were measured on preoperative computed tomographic (CT) images of 324 hips with osteoarthritis and compared with the CT images taken after hip arthroplasty. The PCL rotated 0.4° (±10.9° SD) internally from the HBL on preoperative CT images and was significantly correlated with femoral anteversion, Kellgren-Lawrence grade, and sex. On postoperative CT images, the PCL rotated 10.1° (interquartile range, 1.7°-15.5°) internally from the HBL. There was individual variance in the position of the PCL, and caution may be needed when using it as a rotational reference.