Fig. 6.

Illustrative case for the alignment in flexion of a downsized femoral component. Illustrative case for the alignment in flexion of a downsized femoral component with preservation of the posterior condylar offset (PCO). Size 5 with 0° FFC fits the antero-posterior dimension of the femur, however, mediolateral overhang is observed, which is detrimental. Downsizing the femoral component (Size 4, 0° FFC) reduces the mediolateral overhang, but creates anterior notching of the femoral cortex, if the PCO is preserved. Flexing the smaller component by a few degrees in the sagittal plane (Size 4, 6° FFC) may concomitantly preserve the PCO, while limiting mediolateral overhang and preventing anterior notching