Skip to main content
SpringerLink
Log in

Intraoperative anthropomorphic study of anterior femoral condyles compared with sizing of femoral arthroplasty

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The present study was designed to compare the dimensions of the anterior femoral condyle with those of the anterior component flange using intraoperative morphological data.

Methods

Overall, 1227 knees in 962 patients were included in this study. The height of the anterior lateral/medial condylar height (ALCH/AMCH) was measured and compared between men and women. These morphological data were compared with the dimensions of the chosen component for each patient. The lateral/medial anterior femoral offset was calculated, and the over-/understuffing rates were compared between men and women.

Results

The median ALCH in men was 8.5 mm (6.5, 10.0 mm) versus 7.0 mm (6.0, 9.0 mm) in women. The median AMCH in men was 4.0 mm (2.5, 6.0 mm) versus 3.5 mm (2.5, 6.0 mm) in women. There was a significant difference between the genders with respect to ALCH (p < 0.05). When the dimensions of the component were compared with those of the native knee, the anterior lateral flange height was smaller than the native knees (1.3 mm in male, 0.7 mm in female), but the anterior medial flange height was larger than the corresponding condyle (1.8 mm in male, 1.8 mm in female). A significant difference was observed between the genders with respect to the ideal fit rate of ALCH (p < 0.01).

Conclusion

The results demonstrate that gender differences exist in the anterior lateral condyles of knees. The anterior flange of component is not designed to precisely reproduce normal trochlear anatomy.

Level of evidence

II.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Abolghasemian M, Samiezadeh S, Sternheim A, Bougherara H, Barnes CL, Backstein DJ (2014) Effect of patellar thickness on knee flexion in total knee arthroplasty: a biomechanical and experimental study. J Arthroplasty 29(1):80–84

    Article  PubMed  Google Scholar 

  2. Barnes CL, Iwaki H, Minoda Y, Green JM 2nd, Obert RM (2010) Analysis of sex and race and the size and shape of the distal femur using virtual surgery and archived computed tomography images. J Surg Orthop Adv 19(4):200–208

    PubMed  Google Scholar 

  3. Barrack RL, Schrader T, Bertot AJ, Wolfe MW, Myers L (2001) Component rotation and anterior knee pain after total knee arthroplasty. Clin Orthop Relat Res 392:46–55

    Article  PubMed  Google Scholar 

  4. Bellemans J, Carpentier K, Vandenneucker H, Vanlauwe J, Victor J (2010) The John Insall Award: both morphotype and gender influence the shape of the knee in patients undergoing TKA. Clin Orthop Relat Res 468(1):29–36

    Article  PubMed  PubMed Central  Google Scholar 

  5. Conley S, Rosenberg A, Crowninshield R (2007) The female knee: anatomic variations. J Am Acad Orthop Surg 15(Suppl 1):S31–S36

    Article  PubMed  Google Scholar 

  6. Dejour D, Ntagiopoulos P, Saffarini M (2014) Evidence of trochlear dysplasia in femoral component designs. Knee Surg Sports Traumatol Arthrosc 22(11):2599–2607

    Article  PubMed  Google Scholar 

  7. Fehring TK, Odum SM, Hughes J, Springer BD, Beaver WB Jr (2009) Differences between the sexes in the anatomy of the anterior condyle of the knee. J Bone Joint Surg Am 91(10):2335–2341

    Article  PubMed  Google Scholar 

  8. Ghosh KM, Merican AM, Iranpour F, Deehan DJ, Amis AA (2009) The effect of overstuffing the patellofemoral joint on the extensor retinaculum of the knee. Knee Surg Sports Traumatol Arthrosc 17(10):1211–1216

    Article  CAS  PubMed  Google Scholar 

  9. 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 Joint Surg Br 93(3):357–363

    Article  CAS  PubMed  Google Scholar 

  10. Hitt K, Shurman JR, 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 Joint Surg Am 85A:115–122

    Google Scholar 

  11. Kainz H, Reng W, Augat P, Wurm S (2012) Influence of total knee arthroplasty on patellar kinematics and contact characteristics. Int Orthop 36(1):73–78

    Article  PubMed  PubMed Central  Google Scholar 

  12. Kawahara S, Matsuda S, Fukagawa S, Mitsuyasu H, Nakahara H, Higaki H, Shimoto T, Iwamoto Y (2012) Upsizing the femoral component increases patellofemoral contact force in total knee replacement. J Bone Joint Surg Br 94(1):56–61

    Article  CAS  PubMed  Google Scholar 

  13. Keshmiri A, Maderbacher G, Baier C, Sendtner E, Schaumburger J, Zeman F, Grifka J, Springorum HR (2015) The influence of component alignment on patellar kinematics in total knee arthroplasty. Acta Orthop 86(4):444–450

    Article  PubMed  PubMed Central  Google Scholar 

  14. Lachiewicz PF, Henderson RA (2013) Patient-specific instruments for total knee arthroplasty. J Am Acad Orthop Surg 21(9):513–518

    PubMed  Google Scholar 

  15. Li P, Tsai T-Y, Li J-S, Wang S, Zhang Y, Kwon Y-M, Rubash HE, Li G (2014) Gender analysis of the anterior femoral condyle geometry of the knee. Knee 21(2):529–533

    Article  PubMed  Google Scholar 

  16. Lonner J, Jasko J, Thomas B (2008) Anthropomorphic differences between the distal femora of men and women. Clin Orthop Relat Res 466(11):2724–2729

    Article  PubMed  PubMed Central  Google Scholar 

  17. Ma HM, Lu YC, Kwok TG, Ho FY, Huang CY, Huang CH (2007) The effect of the design of the femoral component on the conformity of the patellofemoral joint in total knee replacement. J Bone Joint Surg Br 89B(3):408–412

    Article  Google Scholar 

  18. Merchant AC, Arendt EA, Dye SF, Fredericson M, Grelsamer RP, Leadbetter WB, Post WR, Teitge RA (2008) The female knee: anatomic variations and the female-specific total knee design. Clin Orthop Relat Res 466(12):3059–3065

    Article  PubMed  PubMed Central  Google Scholar 

  19. Mihalko W, Fishkin Z, Krakow K (2006) Patellofemoral overstuff and its relationship to flexion after total knee arthroplasty. Clin Orthop Relat Res 449:283–287

    Article  PubMed  Google Scholar 

  20. Pinskerova V, Nemec K, Landor I (2014) Gender differences in the morphology of the trochlea and the distal femur. Knee Surg Sports Traumatol Arthrosc 22(10):2342–2349

    Article  CAS  PubMed  Google Scholar 

  21. Poilvache PL, Insall JN, Scuderi GR, Font-Rodriguez DE (1996) Rotational landmarks and sizing of the distal femur in total knee arthroplasty. Clin Orthop Relat Res 331:35–46

    Article  PubMed  Google Scholar 

  22. Varadarajan KM, Rubash HE, Li G (2011) Are current total knee arthroplasty implants designed to restore normal trochlear groove anatomy? J Arthroplasty 26(2):274–281

    Article  PubMed  Google Scholar 

  23. Yang B, Song CH, Yu JK, Yang YQ, Gong X, Chen LX, Wang YJ, Wang J (2014) Intraoperative anthropometric measurements of tibial morphology: comparisons with the dimensions of current tibial implants. Knee Surg Sports Traumatol Arthrosc 22(12):2924–2930

    Article  PubMed  Google Scholar 

  24. Yue B, Varadarajan KM, Ai S, Tang T, Rubash HE, Li G (2011) Differences of knee anthropometry between Chinese and white men and women. J Arthroplasty 26(1):124–130

    Article  PubMed  PubMed Central  Google Scholar 

  25. Zaffagnini S, Bignozzi S, Saffarini M, Colle F, Sharma B, Kinov PS, Marcacci M, Dejour D (2014) Comparison of stability and kinematics of the natural knee versus a PS TKA with a ‘third condyle’. Knee Surg Sports Traumatol Arthrosc 22(8):1778–1785

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was funded by the Beijing Science and Technology Planning Projects of Beijing Science and Technology Committee (No. Z131100005213004), Instrument Research Project of the National Natural Science Foundation (No. 81327001).

Author information

Author notes

    Authors and Affiliations

    1. Institute of Sports Medicine, Peking University Third Hospital, No. 49, North Garden Road, Haidian District, Beijing, 100191, China

      Ai-Bing Huang, Hai-Jun Wang, Bo Yang, Chang-Hui Song, Ji-Ying Zhang & Jia-Kuo Yu

    Authors
    1. Ai-Bing Huang
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. Hai-Jun Wang
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. Bo Yang
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. Chang-Hui Song
      View author publications

      You can also search for this author in PubMed Google Scholar

    5. Ji-Ying Zhang
      View author publications

      You can also search for this author in PubMed Google Scholar

    6. Jia-Kuo Yu
      View author publications

      You can also search for this author in PubMed Google Scholar

    Corresponding author

    Correspondence to Jia-Kuo Yu.

    Additional information

    Ai-Bing Huang and Hai-Jun Wang have contributed equally to this work.

    Rights and permissions

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Huang, AB., Wang, HJ., Yang, B. et al. Intraoperative anthropomorphic study of anterior femoral condyles compared with sizing of femoral arthroplasty. Knee Surg Sports Traumatol Arthrosc 24, 1280–1285 (2016). https://doi.org/10.1007/s00167-015-3957-1

    Download citation

    • Received:

    • Accepted:

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1007/s00167-015-3957-1

    Keywords

    Search

    Navigation