Volume 13 Issue 10

Submission: 12 July 2025   |   Acceptance: 21 August 2025   |   Publication: 7 October 2025

Impact of posterior femoral condylar offset restoration on knee range of motion in total knee arthroplasty patients. A retrospective case series study

¹Dr Kher Muhammad, ²Dr Shams Ur Rehman, ³Dr Syed Imran Bukhari, ⁴Dr Farhad khan, ⁵Dr Muhammad Shabir, ⁶Dr Aimal Sattar

¹Fellow Arthoplasty orthopaedic department LRH/MTI Peshawar
²Associate Professor Orthopaedic department LRH MTI Peshawar
³Associate Professor Orthopaedic department LRH MTI Peshawar
⁴Fellow Arthoplasty LRH /MTI Peshawar  
⁵Professor Orthopaedic department LRH MTI Peshawar
⁶Assistant Professor Orthopaedic Department LRH MTI Peshawar

Corresponding Author:  Dr Farhad Khan


Abstract
Background
Total knee replacement (TKR) is a proven intervention for alleviating pain and restoring function in patients with advanced knee osteoarthritis. Accurate radiographic assessment of femoral posterior condylar offset (PFCO) and its restoration is vital for optimizing surgical outcomes and enhancing patient satisfaction. However the extent of this relationship remains unclear.
Objectives
This study aims to compare preoperative and postoperative radiographic measurements of PFCO in patients underwent TKR, evaluating their influence on postoperative range of motion (ROM) and clinical outcomes.
Methods
This retrospective case series study was performed on patients aged 55 to 80 who underwent primary TKR and had complete preoperative and postoperative imaging and follow up data for 6 months at Lady Reading Hospital. Preoperative and postoperative lateral knee radiographs were evaluated to measure PFCO and knee ROM was assed preoperatively and at 1, 3, and 6 months postoperatively. Statistical analyses were conducted to determine correlations between these measurements and postoperative ROM.
Results
The study included 50 patients. Postoperative assessments showed significant changes in PFCO compared to preoperative measurements. The mean preoperative PFCO was 33.05 mm and increased to 35.67mm postoperatively (p< 0.0001). Mean preoperative flexion angle was 115.1⁰, improving to 126.6⁰ postoperatively (p <0.001). The mean gain in PFCO was +2.38 mm and in flexion angle was +10.16⁰.  A moderate positive correlation was found between PFCO restoration and postoperative flexion improvement (r= 0.138, p= 0.34)
Conclusion
 Although PFCO restoration significantly improved post TKR flexion, its direct relationship with flexion gain was modest, indicating that multiple surgical and rehabilitative factors influence functional recovery. So a comprehensive approach is essential to optimize ROM outcome.
Key words. TKR (total knee replacement), OA (osteoarthritis), PFCO (posterior femoral condylar offset), ROM, (range of motion)