Anthropometric measurements of patella and its clinical implications

  • Rohit JainEmail author
  • Roop Bhushan Kalia
  • Lakshmana Das
Original Article • KNEE - ANATOMY



Early patellar failures in tricompartmental total knee arthroplasty (TKA) have been related to universal designing of implants. Establishing the appropriate patellar bone–prosthesis composite thickness is one of the important steps in ensuring functional success in arthroplasty. Since there is a paucity of data concerning the anthropometric measurements of Indian patella, the objective of this study was to obtain anatomic information of the patella of the northern Indian population and to analyze how it differs from western patellae that will improve patellar component design and implantation in TKA.

Materials and methods

A total of 266 consecutive knee radiographs were evaluated. All data were collected by a single doctor using X-ray console, where height (mm) and breadth (mm) were taken in anteroposterior views and thickness (mm) in lateral view.


The mean, standard deviation, 95% confidence interval and P value of the measurements were calculated. It was found that Indians had thinner and smaller patella as compared to westerners and also males had significantly (P < .001) larger patella as compared to females.


Anthropometric patellar dimensions can influence implant design and surgical outcomes and can be used as a guideline for future designing of more regional and gender-specific patellar component and patellar plate.


Patella Anthropometry Arthroplasty TKR 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Baldwin JL, House CK (2005) Anatomic dimensions of the patella measured during total knee arthroplasty. J Arthroplasty 20:250–257CrossRefGoogle Scholar
  2. 2.
    Iranpour F, Merican AM, Cobb JP, Amis AA (2008) The width: thickness ratio of the patella: an aid in knee arthroplasty. Clin Orthop Relat Res 466:1198–1203CrossRefGoogle Scholar
  3. 3.
    Hsu HC, Luo ZP, Rand JA, An KN (1996) Influence of patellar thickness on patellar tracking and patellofemoral contact characteristics after total knee arthroplasty. J Arthroplasty 11:69–80CrossRefGoogle Scholar
  4. 4.
    Oishi CS, Kaufman KR, Irby SE, Colwell CW Jr (1996) Effects of patellar thickness on compression and shear forces in total knee arthroplasty. Clin Orthop Relat Res 331:283–285CrossRefGoogle Scholar
  5. 5.
    Kim T, Chung B, Kang Y, Chang C, Seong S (2009) Clinical implications of anthropometric patellar dimensions for TKA in Asians. Clin Orthop Relat Res 467:1007–1014CrossRefGoogle Scholar
  6. 6.
    Vaidya SV, Ranawat CS, Aroojis A, Laud NS (2000) Anthropometric measurements to design total knee prostheses for the Indian population. J Arthroplasty 15:79–85CrossRefGoogle Scholar
  7. 7.
    Uehara K, Kadoya Y, Kobayashi A, Ohashi H, Yamano Y (2002) Anthropometry of the proximal tibia to design a total knee prosthesis for the Japanese population. J Arthroplasty 17:1028–1032CrossRefGoogle Scholar
  8. 8.
    Ho WP, Cheng CK, Liau JJ (2006) Morphometrical measurements of resected surface of femurs in Chinese knees: correlation to the sizing of current femoral implants. Knee 13:12–14CrossRefGoogle Scholar
  9. 9.
    Kwak DS, Surendran S, Pengatteeri YH, Park SE, Choi KN, Gopinathan P et al (2007) Morphometry of the proximal tibia to design the tibial component of total knee arthroplasty for the Korean population. Knee 14:295–300CrossRefGoogle Scholar
  10. 10.
    Lim HC, Bae JH, Yoon JY, Kim SJ, Kim JG, Lee JM (2013) Gender differences of the morphology of the distal femur and proximal tibia in a Korean population. Knee 20:26–30CrossRefGoogle Scholar
  11. 11.
    Sharkey PF, Hozack WJ, Rothman RH, Shastri S, Jacoby SM (2002) Why are total knee arthroplasties failing today? Clin Orthop Relat Res 404:7–13CrossRefGoogle Scholar
  12. 12.
    Doane DP, Seward LE (2011) Measuring skewness: A forgotten statistic? J Stat Educ 19(2):1–18CrossRefGoogle Scholar
  13. 13.
    Razali NM, Wah YB (2011) Power comparison of Shapiro–Wilk, Kolmogorov–Smironov, Lillifors and Anderson–Darling tests. J Stat Mod Anal 2(1):21–23Google Scholar
  14. 14.
    Sullivan NPT, Robinson PW, Ansari A, Hassaballa M, Robinson JR, Porteous AJ et al (2014) Bristol index of patellar width to thickness (BIPWiT): a reproducible measure of patellar thickness from adult MRI. Knee 21(6):1058–1062CrossRefGoogle Scholar
  15. 15.
    Peng S, Linan Z, Zengtao H, Xueling B, Xin Y, Zhaobin X et al (2014) Morphometric measurement of the patella on 3D model reconstructed from CT scan images for the southern Chinese population. Chin Med J 127(1):96–101Google Scholar
  16. 16.
    Berry DJ, Rand JA (1993) Isolated patellar component revision of total knee arthroplasty. Clin Orthop Relat Res 268:110–115Google Scholar
  17. 17.
    Murugan M, Ambika S, Nim VK (2017) Knee cap: a morphometric study. Int J Anat Res 25(1):3556–3559CrossRefGoogle Scholar
  18. 18.
    Olateju OL, Philander I, Bidmos MA (2013) Morphometric analysis of the patella and patellar ligament of South Africans of European ancestry. S Afr J Sci 109(9/10):1–5CrossRefGoogle Scholar
  19. 19.
    Cohen ZA, Mow VC, Henry JH, Levine WN, Ateshian GA (2003) Templates of the cartilage layers of the patellofemoral joint and their use in the assessment of osteoarthritic cartilage damage. Osteoarthr Cartil 11:569–579CrossRefGoogle Scholar
  20. 20.
    Hardy PA, Nammalwar P, Kuo S (2001) Measuring the thickness of articular cartilage from MR images. J Magn Reson Imaging 13:120–126CrossRefGoogle Scholar
  21. 21.
    Meachim G, Bentley G, Baker R (1977) Effect of age on thickness of adult patellar articular cartilage. Ann Rheum Dis 36:563–568CrossRefGoogle Scholar

Copyright information

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

Authors and Affiliations

  • Rohit Jain
    • 1
    Email author
  • Roop Bhushan Kalia
    • 1
  • Lakshmana Das
    • 1
  1. 1.All India Institute of Medical Sciences (AIIMS)RishikeshIndia

Personalised recommendations