Medial Condyle of Femur

The medial condyle of the femur is a large, rounded prominence located on the medial aspect of the distal femur. It plays a critical role in forming the knee joint by articulating with the medial condyle of the tibia. Larger than the lateral condyle, the medial condyle extends more distally and is involved in load distribution, joint stability, and movement of the lower limb. Its structural prominence and asymmetry are essential to the valgus alignment of the knee and the smooth articulation of the femur during flexion and extension.

Structure

The medial condyle is an ellipsoid structure composed of dense cortical and subchondral bone covered with thick articular cartilage. It is convex in shape and projects more distally than the lateral condyle, which helps compensate for the obliquity of the femoral shaft. This anatomical adaptation ensures that both condyles make even contact with the tibial plateau in the standing position.

Surfaces

• Articular surface: Covered by hyaline cartilage, articulates with the medial tibial condyle and posterior aspect of the patella.
• Posterior surface: Curved and blends into the popliteal surface, important in knee flexion mechanics.
• Medial epicondyle: A raised prominence superior to the condyle, serving as an important site for ligament attachment.

Trochlear and Intercondylar Features

• Trochlear surface: The anterior surface of the femur continues onto the condyles, forming a groove for the patella. The medial trochlear lip is less prominent than the lateral lip.
• Intercondylar fossa: A deep notch posteriorly separating the medial and lateral condyles, which houses the cruciate ligaments.

Location

The medial condyle is located at the distal, medial portion of the femur. It is positioned inferiorly and slightly posteriorly relative to the shaft, projecting further distally than its lateral counterpart. This anatomical asymmetry helps align the knee joint properly during weight-bearing and standing.

• Superior: Femoral shaft and medial supracondylar ridge
• Inferior: Medial tibial condyle
• Anterior: Patella via the patellofemoral joint
• Posterior: Origin of the medial head of the gastrocnemius

Function

• Articulation: Forms the medial half of the tibiofemoral joint, allowing for flexion and extension of the knee.
• Load bearing: Bears a significant portion of the body’s weight, especially during standing and walking.
• Knee alignment: The greater distal projection of the medial condyle contributes to the valgus angle of the femur, aligning the knee joint horizontally during stance.

Articulations

The medial condyle is involved in two major articulations:

Joint	Articulating Structures	Joint Type
Tibiofemoral joint	Medial femoral condyle with medial tibial condyle	Synovial hinge joint
Patellofemoral joint	Anterior aspect of condyle with posterior surface of patella	Synovial plane/gliding joint

Ligament and Muscle Attachments

The medial condyle and its surrounding structures serve as attachment points for key ligaments and muscles stabilizing the knee.

Structure	Attachment Site	Function
Medial collateral ligament (MCL)	Medial epicondyle	Resists valgus stress at the knee
Adductor magnus (hamstring part)	Adductor tubercle (just superior to medial epicondyle)	Assists in thigh extension and hip stabilization
Medial head of gastrocnemius	Posterior aspect of medial condyle	Plantarflexion of foot and knee flexion

Blood Supply

The medial condyle is supplied by genicular branches of the femoral, popliteal, and descending genicular arteries. These arteries contribute to a dense vascular network around the knee joint:

• Superior medial genicular artery: Supplies the area around the medial epicondyle and anterior knee
• Inferior medial genicular artery: Supplies the lower aspect of the medial condyle
• Descending genicular artery: Provides additional supply during knee flexion

Nerve Supply

The medial condyle and associated structures receive innervation from articular branches of the:

• Femoral nerve: Supplies the anterior knee capsule and periosteum
• Obturator nerve: Sends posterior articular branches to the medial capsule
• Tibial nerve: Innervates the posterior aspect and the origin of the gastrocnemius muscle

Ossification

The medial condyle develops from a secondary ossification center. It appears during infancy and fuses with the femoral shaft during adolescence.

• Center appears: Around 9 months postnatal
• Fusion complete: By 16–18 years of age

Proper development and ossification are essential for maintaining symmetrical load distribution and joint integrity.

Clinical Significance

• Medial femoral condyle fractures: May result from direct trauma or high-stress injuries. Often intra-articular and require careful alignment to prevent joint dysfunction.
• Osteochondritis dissecans: The medial condyle is the most common site for this condition, characterized by focal subchondral bone necrosis and potential cartilage detachment.
• Osteoarthritis: Medial compartment knee osteoarthritis is more common than lateral, due to higher weight-bearing load on the medial condyle. Leads to joint space narrowing, sclerosis, and osteophyte formation.
• Bone marrow edema: MRI may show signal changes in the medial condyle in early stress or inflammatory conditions.
• Chondral lesions: Cartilage defects over the articular surface can result in pain and mechanical symptoms.

Imaging

Imaging is crucial in assessing the anatomy and pathology of the medial condyle:

• X-ray: AP and lateral knee radiographs show joint space, bony contour, and degenerative changes.
• MRI: Preferred modality for visualizing cartilage, subchondral bone, bone marrow changes, and early osteonecrosis.
• CT scan: Offers detailed bone visualization, especially for fractures and surgical planning.

The Rosenberg view (posteroanterior weight-bearing at 45° flexion) is particularly useful in detecting early medial compartment narrowing due to osteoarthritis.