The lateral femoral condyle is the smaller and shorter of the two femoral condyles, projecting slightly less distally than the medial condyle in proportion to the valgus axis of the limb. Its lateral surface gives attachment to the lateral collateral ligament and the popliteofibular ligament. The posterior articular surface of the lateral condyle, along with the intercondylar notch wall, is the femoral attachment of the ACL. The lateral condyle bears the primary load in valgus knee alignment.
The lateral femoral condyle is involved in several specific pathologies: IT band friction syndrome where the band impinges against the lateral epicondyle at 30 degrees of flexion; bone bruising of the lateral condyle and posterior lateral tibial plateau is the classic MRI pattern in ACL tears from the pivot shift mechanism; osteochondral defects of the lateral condyle occur in patellar dislocation where the medial patellar facet impacts the lateral condyle. Lateral condyle stress fractures occur in children from repetitive valgus loading.
The pivot shift mechanism of ACL injury drives the lateral tibial plateau against the posterior lateral femoral condyle, producing the classic bone bruise pattern visible as T2 oedema on MRI at these two locations, providing retrospective evidence of the pivot shift mechanism even when the ACL tear itself is partial.
Lateral patellar dislocation impacts the medial patellar facet against the lateral femoral condyle, shearing the articular cartilage and subchondral bone of the condyle to produce a loose osteochondral fragment requiring arthroscopic retrieval and assessment of the defect.
