Location of the femoral sulcus in the osteoarthritic knee

Morphology of the distal femur is characterized in patients with osteoarthritis to identify an etiology for the high incidence of patellar tilt, subluxation, and failure noted in total knee arthroplasty. This study demonstrates that the sulcus of the trochlear groove is not located in the midline as traditionally represented, but is lateral to the midline in both osteoarthritic and normal knees. The significance of this is that the patella will presumably track lateral to the midline unless surgically realigned, contributing to the prevalence of patellar tracking problems associated with symmetric femoral components with centralized sulci used in contemporary total knee arthroplasty.