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Youm, Cho, Lee, Hwang, and Kang: Morphometric Differences of Distal Femoral Cut Surface between Korean Male and Female in Total Knee Arthroplasty
Original Article

Journal of the Korean Orthopaedic Association 2016; 51(2): 151-157.

Published online: 22 April 2016

DOI: https://doi.org/10.4055/jkoa.2016.51.2.151

Morphometric Differences of Distal Femoral Cut Surface between Korean Male and Female in Total Knee Arthroplasty

Yoon-Seok Youm, M.D., Sung-Do Cho, M.D., Seon-Ho Lee, M.D., Il-Yeong Hwang, M.D., Tae-Wook Kang, M.D.

Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.

Correspondence to: Sung-Do Cho, M.D. Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwan-doro, Dong-gu, Ulsan 44033, Korea. TEL: +82-52-250-7129, FAX: +82-52-235-2823, sdcho@uuh.ulsan.kr

Received 15 July 2015       Revised 24 August 2015       Accepted 25 August 2015

Copyright © 2016 by The Korean Orthopaedic Association

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study is to evaluate the morphometric differences of distal femoral cut surface between Korean males and females in total knee arthroplasty.

Materials and Methods

A total of 696 patients (1,008 knees: male 92, female 916) who underwent TKA using NexGen® legacy posteriorstabilized (LPS) (605 knees: male 41, female 564) and PS ADVANCE® medical pivot knee (MPK) (403 knees: male 51, female 352) implants were analyzed prospectively. After distal femoral resection, the mediolateral width (ML) was measured at four points (anterior [Ant], distal anterior [DA], distal posterior [DP], and posterior [Post]) and compared with the ML width of the implant respectively. The aspect ratio (AR=ML/anteroposterior width) and width ratio (WR=Ant ML/DP ML) were calculated. Differences in AR, WR, and fitness between male and female were analyzed.

Results

The AR of males was larger than that of females for both LPS and MPK; however, no differences in the WR were observed between males and females. The WR in MPK was larger than that in LPS. For both LPS and MPK, females showed greater anatomical fitness than males, and males had relatively greater incidence of undersize than females. For MPK, there were relatively more cases of overhang in Ant and DA cut surface. These results were consistent with the fact that the WR of implant in MPK was larger than that in LPS.

Conclusion

Korean males tend to have larger AR and less anatomical fitness of the femoral component than females because of undersize. No difference in WR was observed between Korean males and females. However, the cut surfaces as well as femoral implant of MPK had larger WR than those of LPS. MPK has more overhang on the anterior cut surface than LPS, due to a wider Ant flange (larger WR) of the implant.

Keywords: total knee arthroplasty, distal femoral cut, morphometry, fitness, gender difference

Figures and Tables

Figure 1

Medio-lateral width of the distal femur at four points. DP, distal posterior; Post, posterior; Ant, anterior; DA, distal anterior.

jkoa-51-151-g001
Figure 2

Medio-lateral width of the femoral implant at four points. Post, posterior; DP, distal posterior; DA, distal anterior; Ant, anterior.

jkoa-51-151-g002
Figure 3

The aspect ratio was defined as the mediolateral width (ML) divided by the anteroposterior width (AP).

jkoa-51-151-g003
Figure 4

The width ratio was defined as the anterior (Ant) medio-lateral width divided by the distal posterior (DP) medio-lateral width.

jkoa-51-151-g004
Table 1

Female vs. Male in Aspect Ratio (AR) and Width Ratio (WR)

jkoa-51-151-i001

Values are presented as mean±standard deviation. LPS, legacy posterior-stabilized; MPK, medical pivot knee; AR, aspect ratio; WR, width ratio.

Table 2

Fitness of Implants (Optimal Cases of Male vs. Female)

jkoa-51-151-i002

LPS, legacy posterior-stabilized; MPK, medical pivot knee.

Notes

CONFLICTS OF INTEREST The authors have nothing to disclose.

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