Advertisement

Difference in coronal curvature of the medial and lateral femoral condyle morphology by gender in implant design for total knee arthroplasty

  • Yong-Gon Koh
  • Ji-Hoon Nam
  • Hyun-Seok Chung
  • Kyoung-Tak KangEmail author
Original Article
  • 20 Downloads

Abstract

Purpose

The purpose of this study was to investigate the morphometric data obtained from the three-dimensional magnetic resonance images of ethnic Korean knee osteoarthritis, and to evaluate the morphological differences between the coronal curvature of the female and male femoral condyles.

Methods

The differences in coronal curvature of the femoral condyle morphology of 1990 patients (1689 females and 301 males) were evaluated in three dimensions. A close-fit diameter was, respectively, generated on the medial and lateral femoral condyle articular surfaces, and these diameters reflect the coronal diameter of the femoral condyle curvature. These measurements were compared with those of the femoral design of five different commonly used total knee arthroplasty (TKA) implant designs.

Results

The average diameter of the curvature of the medial condyles was significantly larger than that of the lateral condyles (P < 0.05). This trend was found in the male and female groups. In addition, the average diameter of the curvature of the femoral condyles was found to significantly differ between males and females (P < 0.05). For four TKA implant designs, the average diameter of the coronal curvature of femoral condyle was smaller than that obtained via our measurements, whereas one TKA implant design yielded a smaller average diameter. Furthermore, the medial and lateral coronal curvatures of the femoral condyle were symmetric in all TKA implant designs.

Conclusion

The study provided a reliable and consistent evaluation of the coronal curvature of femoral condyles in the Korean population. These results showed that a gender-specific or asymmetric femoral component design is required to regenerate the coronal curvature of the femoral condyles for ethnically Korean males and females.

Keywords

Korean patients Morphometry Femur condyles Coronal radius 

Notes

Funding

There was no funding for this study.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

References

  1. 1.
    Asseln M, Hanisch C, Schick F, Radermacher K (2018) Gender differences in knee morphology and the prospects for implant design in total knee replacement. Knee 25(4):545–558CrossRefGoogle Scholar
  2. 2.
    Blaha JD, Mancinelli CA, Overgaard KA (2009) Failure of sex to predict the size and shape of the knee. J Bone Jt Surg Am 91(Suppl 6):19–22CrossRefGoogle Scholar
  3. 3.
    Bull AM, Kessler O, Alam M, Amis AA (2008) Changes in knee kinematics reflect the articular geometry after arthroplasty. Clin Orthop Relat Res 466(10):2491–2499CrossRefGoogle Scholar
  4. 4.
    Cheng FB, Ji XF, Zheng WX, Lai Y, Cheng KL, Feng JC, Li YQ (2010) Use of anthropometric data from the medial tibial and femoral condyles to design unicondylar knee prostheses in the Chinese population. Knee Surg Sports Traumatol Arthrosc 18(3):352–358CrossRefGoogle Scholar
  5. 5.
    Chin KR, Dalury DF, Zurakowski D, Scott RD (2002) Intraoperative measurements of male and female distal femurs during primary total knee arthroplasty. J Knee Surg 15(4):213–217PubMedGoogle Scholar
  6. 6.
    Conley S, Rosenberg A, Crowninshield R (2007) The female knee: anatomic variations. JAAOS J Am Acad Orthop Surg 15:S31–S36CrossRefGoogle Scholar
  7. 7.
    Gillespie RJ, Levine A, Fitzgerald SJ, Kolaczko J, DeMaio M, Marcus RE, Cooperman DR (2011) Gender differences in the anatomy of the distal femur. J Bone Jt Surg Br 93(3):357–363CrossRefGoogle Scholar
  8. 8.
    Griffin FM, Math K, Scuderi GR, Insall JN, Poilvache PL (2000) Anatomy of the epicondyles of the distal femur: MRI analysis of normal knees. J Arthroplasty 15(3):354–359CrossRefGoogle Scholar
  9. 9.
    Han H, Oh S, Chang CB, Kang SB (2016) Anthropometric difference of the knee on MRI according to gender and age groups. Surg Radiol Anat 38(2):203–211CrossRefGoogle Scholar
  10. 10.
    Hitt K, Shurman JR 2nd, Greene K, McCarthy J, Moskal J, Hoeman T, Mont MA (2003) Anthropometric measurements of the human knee: correlation to the sizing of current knee arthroplasty systems. J Bone Jt Surg Am 85-A(Suppl 4):115–122CrossRefGoogle Scholar
  11. 11.
    Hohe J, Ateshian G, Reiser M, Englmeier KH, Eckstein F (2002) Surface size, curvature analysis, and assessment of knee joint incongruity with MRI in vivo. Magn Reson Med 47(3):554–561CrossRefGoogle Scholar
  12. 12.
    Kang KT, Son J, Kwon OR, Baek C, Heo DB, Park KM, Kim HJ, Koh YG (2016) Morphometry of femoral rotation for total knee prosthesis according to gender in a Korean population using three-dimensional magnetic resonance imaging. Knee 23(6):975–980CrossRefGoogle Scholar
  13. 13.
    Koh YG, Nam JH, Chung HS, Lee HY, Kim HJ, Kim HJ, Kang KT (2019) Gender-related morphological differences in sulcus angle and condylar height for the femoral trochlea using magnetic resonance imaging. Knee Surg Sports Traumatol Arthrosc 27(11):3560–3566CrossRefGoogle Scholar
  14. 14.
    Lonner JH, Jasko JG, Thomas BS (2008) Anthropomorphic differences between the distal femora of men and women. Clin Orthop Relat Res 466(11):2724–2729CrossRefGoogle Scholar
  15. 15.
    Mahfouz M, Abdel Fatah EE, Bowers LS, Scuderi G (2012) Three-dimensional morphology of the knee reveals ethnic differences. Clin Orthop Relat Res 470(1):172–185CrossRefGoogle Scholar
  16. 16.
    Monk AP, Choji K, O’Connor JJ, Goodfellow JW, Murray DW (2014) The shape of the distal femur: a geometrical study using MRI. Bone Jt J 96-b(12):1623–1630CrossRefGoogle Scholar
  17. 17.
    Most E, Li G, Schule S, Sultan P, Park SE, Zayontz S, Rubash HE (2003) The kinematics of fixed-and mobile-bearing total knee arthroplasty. Clin Orthop Relat Res 416:197–207CrossRefGoogle Scholar
  18. 18.
    O’Connor JJ, Shercliff TL, Biden E, Goodfellow JW (1989) The geometry of the knee in the sagittal plane. Proc Inst Mech Eng H 203(4):223–233CrossRefGoogle Scholar
  19. 19.
    Siebold R, Axe J, Irrgang JJ, Li K, Tashman S, Fu FH (2010) A computerized analysis of femoral condyle radii in ACL intact and contralateral ACL reconstructed knees using 3D CT. Knee Surg Sports Traumatol Arthrosc 18(1):26–31CrossRefGoogle Scholar
  20. 20.
    Siu D, Rudan J, Wevers HW, Griffiths P (1996) Femoral articular shape and geometry. A three-dimensional computerized analysis of the knee. J Arthroplasty 11(2):166–173CrossRefGoogle Scholar
  21. 21.
    Terzidis I, Totlis T, Papathanasiou E, Sideridis A, Vlasis K, Natsis K (2012) Gender and side-to-side differences of femoral condyles morphology: osteometric data from 360 caucasian dried femori. Anat Res Int 2012:679658PubMedPubMedCentralGoogle Scholar
  22. 22.
    Wang J, Yue B, Wang Y, Yan M, Zeng Y (2012) The 3D analysis of the sagittal curvature of the femoral trochlea in the Chinese population. Knee Surg Sports Traumatol Arthrosc 20(5):957–963CrossRefGoogle Scholar
  23. 23.
    Yang B, Yu JK, Zheng ZZ, Lu ZH, Zhang JY, Cheng JH (2013) Computed tomography morphometric study of gender differences in osteoarthritis proximal tibias. J Arthroplasty 28(7):1117–1120CrossRefGoogle Scholar
  24. 24.
    Yazar F, Imre N, Battal B, Bilgic S, Tayfun C (2012) Is there any relation between distal parameters of the femur and its height and width? Surg Radiol Anat 34(2):125–132CrossRefGoogle Scholar
  25. 25.
    Yue B, Varadarajan KM, Ai S, Tang T, Rubash HE, Li G (2011) Gender differences in the knees of Chinese population. Knee Surg Sports Traumatol Arthrosc 19(1):80–88CrossRefGoogle Scholar
  26. 26.
    Zoghi M, Hefzy MS, Fu KC, Jackson WT (1992) A three-dimensional morphometrical study of the distal human femur. Proc Inst Mech Eng H 206(3):147–157CrossRefGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  • Yong-Gon Koh
    • 1
  • Ji-Hoon Nam
    • 2
  • Hyun-Seok Chung
    • 1
  • Kyoung-Tak Kang
    • 2
    Email author
  1. 1.Department of Orthopaedic Surgery, Joint Reconstruction CenterYonsei Sarang HospitalSeoulRepublic of Korea
  2. 2.Department of Mechanical EngineeringYonsei UniversitySeoulRepublic of Korea

Personalised recommendations