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Objective This study aimed to evaluate variations in anterior condylar height (ACH) of the distal femur in varus knee osteoarthritis and evaluate the association between ACH and knee flexion. Design Computed tomography (CT) images of 171 knees (143 patients; age 73.7 ± 8.3 years; 132 females, 39 males) with symptomatic primary knee osteoarthritis and varus alignment undergoing primary total knee arthroplasty, unilateral knee arthroplasty, or high tibial osteotomy were evaluated. Several other anatomic parameters were measured on CT or rad