Anthropomorphic differences between the distal femora of men and women

Jess H Lonner, Jeff G Jasko, Beverly S Thomas, Jess H Lonner, Jeff G Jasko, Beverly S Thomas

Abstract

There is debate about whether distinct designs of femoral components for men and women are needed based on morphologic and size differences between genders. We asked whether anthropomorphic differences exist between the distal femoral dimensions in women and men. We measured the distal femora of 100 women and 100 men intraoperatively after preparation for prosthetic implantation. The measured dimensions included the anteroposterior height from the posterior edge of the medial femoral condyle to the flush anterior cut, the mediolateral width at the transepicondylar axis, the anterior and posterior edges of the anterior chamfer, and the medial and lateral trochlear flanges. These measurements were compared between genders using independent-samples t test. The aspect ratio (a measure of the shape of the distal femur), the ratio between the anteroposterior and mediolateral dimensions, was calculated for men and women to determine whether there is a shape difference between genders. The mean aspect ratio was larger for women than for men (0.84 [range, 0.57-1.03] versus 0.81 [range, 0.066-1.34], respectively). The standard deviation and range of each measurement of size and morphology suggest variability not only between genders but also within genders. Whether the aspect ratios and variations will reflect clinically important differences in outcomes after TKA with available prostheses will require additional study.

Figures

Fig. 1
Fig. 1
A graphic depicts the ratio of AP and ML dimensions of male and female distal femora.

References

    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1016/j.arth.2005.07.020', 'is_inner': False, 'url': 'https://doi.org/10.1016/j.arth.2005.07.020'}, {'type': 'PubMed', 'value': '16877149', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/16877149/'}]}
    2. Bengs BC, Scott RD. The effect of patellar thickness on intraoperative knee flexion and patellar tracking in total knee arthroplasty. J Arthroplasty. 2006;21:650–655.
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '17004613', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/17004613/'}]}
    2. Booth RE. Sex and the total knee: gender-sensitive designs. Orthopedics. 2006;29:836–838.
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '12416902', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/12416902/'}]}
    2. Chin KR, Dalury DF, Zurakowski D, Scott RD. Intraoperative measurements of male and female distal femurs during primary total knee arthroplasty. J Knee Surg. 2002;15:213–217.
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '17766787', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/17766787/'}]}
    2. Conley S, Rosenberg A, Crowninshield R. The female knee: anatomic variations. J Am Acad Orthop Surg. 2007;15(Suppl 1):S31–S36.
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '18350768', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/18350768/'}]}
    2. DeFrances CJ, Cullen KA, Kozack LJ. National Hospital Discharge Survey: 2005 annual summary with detailed diagnosis and procedure data. Vital Health Stat 13. 2007;165:1–209.
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1016/j.arth.2007.04.011', 'is_inner': False, 'url': 'https://doi.org/10.1016/j.arth.2007.04.011'}, {'type': 'PubMed', 'value': '17823013', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/17823013/'}]}
    2. Fisher DA, Dierckman B, Watts M. Looks good but feels bad: factors that contribute to poor results after total knee arthroplasty. J Arthrop. 2007;22(6 Suppl 2):39–42.
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1302/0301-620X.85B1.13212', 'is_inner': False, 'url': 'https://doi.org/10.1302/0301-620x.85b1.13212'}, {'type': 'PubMed', 'value': '14652402', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/14652402/'}]}
    2. Hitt K, Shurman JR, Greene K, McCarthy J, Moskal J, Hoeman T, Mont MA. Anthropometric measurements of the human knee: correlation to the sizing of current knee arthroplasty systems. J Bone Joint Surg Am. 2003;85:115–122.
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '9729810', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/9729810/'}]}
    2. King CA, Iscan MY, Loth SR. Metric and comparative analysis of sexual dimorphism in the Thai femur. J Forensic Sci. 1998;43:954–958.
    1. MacDonald SJ, Charron KD, Bourne RB, Naudie DD, McCalden RW, Rorabeck CH. The John Insall Award: Gender-specific total knee replacement: prospectively collected clinical outcomes. Clin Orthop Relat Res. 2008;466. Doi:10.1007/s11999-008-0430-1.
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1097/01.blo.0000218756.89439.06', 'is_inner': False, 'url': 'https://doi.org/10.1097/01.blo.0000218756.89439.06'}, {'type': 'PubMed', 'value': '16888532', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/16888532/'}]}
    2. Mihalko W, Fishkin Z, Krackow K. Patellofemoral overstuff and its relationship to flexion after total knee arthroplasty. Clin Orthop Relat Res. 2006;449:283–287.
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1097/00003086-199610000-00006', 'is_inner': False, 'url': 'https://doi.org/10.1097/00003086-199610000-00006'}, {'type': 'PubMed', 'value': '8895617', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/8895617/'}]}
    2. Poilvach PL, Insall JN, Scuderi GR, Font-Rodriguez DE. Rotational landmarks and sizing of the distal femur in total knee arthroplasty. Clin Orthop Relat Res. 1996;331:35–46.
    1. Singh JA, Gabriel S, Lewallen D. The impact of gender, age, and preoperative pain severity on pain after TKA. Clin Orthop Relat Res. 2008;466. Doi:10.1007/s11999-008-0399-9.
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1016/S0379-0738(97)00156-4', 'is_inner': False, 'url': 'https://doi.org/10.1016/s0379-0738(97)00156-4'}, {'type': 'PubMed', 'value': '9438371', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/9438371/'}]}
    2. Steyn M, Iscan MY. Sex determination from the femur and tibia in South African Whites. Forensic Sci Int. 1997;90:111–119.
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1016/S0883-5403(00)91285-3', 'is_inner': False, 'url': 'https://doi.org/10.1016/s0883-5403(00)91285-3'}, {'type': 'PubMed', 'value': '10654467', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/10654467/'}]}
    2. Vaidya SV, Ranawat CS, Aroojis A, Laud NS. Anthropometric measurements to design total knee prosthesis for the Indian population. J Arthroplasty. 2000;15:79–85.

Source: PubMed

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