Anthropometric Measurements of the Human Knee

Hitt, Kirby; Shurman, John R.; Greene, Kenneth; McCarthy, Joseph C.; Moskal, Joseph T.; Hoeman, Tim; Mont, Michael A.

doi:10.2106/00004623-200300004-00015

Cited by 307 publications

(109 citation statements)

References 5 publications

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“…A significant difference in knee width was demonstrated between male and female samples and presented the most pronounced component of variation (excluding size). This is in agreement with previous clinical reports (Chin et al, 2002; Hitt et al, 2003) and the industry has even adopted this concept for the development of gender specific implants. Although interesting from a commercial point of view, no evidence of any outcome advantage in the gender-specific design could be demonstrated in randomized clinical trials (Thomsen et al, 2012).…”

Section: Discussionsupporting

confidence: 92%

Statistical Shape Modeling of Skeletal Anatomy for Sex Discrimination: Their Training Size, Sexual Dimorphism, and Asymmetry

Audenaert

Pattyn

Steenackers

et al. 2019

Front. Bioeng. Biotechnol.

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Purpose: Statistical shape modeling provides a powerful tool for describing and analyzing human anatomy. By linearly combining the variance of the shape of a population of a given anatomical entity, statistical shape models (SSMs) identify its main modes of variation and may approximate the total variance of that population to a selected threshold, while reducing its dimensionality. Even though SSMs have been used for over two decades, they lack in characterization of their goodness of prediction, in particular when defining whether these models are actually representative for a given population.Methods: The current paper presents, to the authors' knowledge, the most extent lower limb anatomy shape model considering the pelvis, femur, patella, tibia, fibula, talus, and calcaneum to date. The present study includes the segmented training shapes (n = 542) obtained from 271 lower limb CT scans. The different models were evaluated in terms of accuracy, compactness, generalizability as well as specificity.Results: The size of training samples needed in each model so that it can be considered population covering was estimated to approximate around 200 samples, based on the generalizability properties of the different models. Simultaneously differences in gender and patterns in left-right asymmetry were identified and characterized. Size was found to be the most pronounced sexual discriminator whereas intra-individual variations in asymmetry were most pronounced at the insertion site of muscles.Conclusion: For models aimed at population covering descriptive studies, the number of training samples required should amount a sizeable 200 samples. The geometric morphometric method for sex discrimination scored excellent, however, it did not largely outperformed traditional methods based on discrete measures.

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Section: Discussionsupporting

confidence: 92%

Statistical Shape Modeling of Skeletal Anatomy for Sex Discrimination: Their Training Size, Sexual Dimorphism, and Asymmetry

Audenaert

Pattyn

Steenackers

et al. 2019

Front. Bioeng. Biotechnol.

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“…The tMAP had larger values than tLAP, which is similar to the previous reports (Hitt et al; Kwak et al). However, the size of proximal tibia is larger than the reported results (Wevers et al, 1994;Hitt et al;Kwak et al) of the Asia-Pacific population including Chinese population. In addition, the mean aspect ratio (tML/ tAP) showed the significant difference between male and female in our study (p?0.05), and the shape of tibia in female are narrower and smaller than that in male in the same nationality, which is consistent with previous findings (Kwak et al;Cheng et al;Lim et al, 2013;Piriou et al, 2014).…”

Section: Resultscontrasting

confidence: 54%

Morphological Measurements of the Normal Distal Femur and Proximal Tibia between Han Chinese and Mongolian Chinese in a Healthy Chinese Population

Zhang

Zhao

et al. 2019

Int. J. Morphol.

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This study aims to compare the knee morphological difference between Han and Mongolian Chinese in China. This will improve the knee prostheses design. A total of 37 natural knees of Han Chinese (13 males, 9 females) and Mongolian Chinese (8 males, 7 females) were measured used Mimics medical imaging program, and the parameters included fML (the femoral mediolateral length), fLAP (the femoral lateral condyle anteroposterior length), fMAP (the femoral medial condyle anteroposteriorlength), tML (The tibial mediolateral length) , tLAP (The tibial lateral anteroposteriorlength) and tMAP (the tibial medial anteroposterior length), The aspect ratio (defined as fML/fAP and tML/tAP;). The sizes of femur and tibia of the males were larger than those of the female for Han Chinese (fML, fLAP and fMAP) mean ± standard deviation: 84.

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“…To date, the topic of anatomic differences according to ethnicity has not garnered as much attention as that of the role of gender, which has been the subject of numerous studies [7, 10, 15, 16, 19, 48]. These analyses were key for identifying now well-established anatomic differences in knees of males and females, with the latter having been shown to have narrower mediolateral (ML) to AP aspect ratios [2, 5], less pronounced anterior condyles [7, 12], and greater quadriceps angle [22, 48].…”

Section: Introductionmentioning

confidence: 99%

What Differences in Morphologic Features of the Knee Exist Among Patients of Various Races? A Systematic Review

Kim

Phillips²,

Bhandari

et al. 2017

Clinical Orthopaedics &Amp; Related Research

118

119

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BackgroundMost TKA prostheses are designed based on the anatomy of white patients. Individual studies have identified key anthropometric differences between the knees of the white population and other major ethnic groups, yet there is limited understanding of what these findings may indicate if analyzed collectively.Question/purposeWhat are the differences in morphologic features of the distal femur and proximal tibia among and within various ethnicities?MethodsA systematic review of the PubMed database and a hand-search of article bibliographies identified 235 potentially eligible English-language studies. Studies were excluded if they did not include morphology results or had insufficient data for analysis, were unrelated to the distal femur or proximal tibia, were conducted in pediatric patients or those undergoing unicondylar knee arthroplasty, or bone surface measurements were obtained for trauma products. This left 30 eligible studies (9050 knees). Study quality was assessed and reported as good, fair, or poor according to the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Morphometric data for the distal femur and proximal tibia were available for four ethnic groups: East Asian (23 studies; 5543 knees), white (11 studies; 3111 knees), Indian (three studies; 283 knees), and black (three studies; 113 knees). Although relatively underrepresented, the knees from the Indian and black studies were maintained for hypothesis-generating purposes and to highlight crucial gaps in the data. The two key dimensions for selecting a suitable implant based on a patient’s unique anatomy—AP length and mediolateral (ML) width—were assessed for the femur and tibia, in addition to aspect ratio, calculated by dividing the ML width by the AP length. Study measurement techniques were compared visually when possible to ensure that each pooled study conducted a similar measurement process. Any significant measurement outliers were reviewed for eligibility to determine if the measurement techniques and landmarks used were comparable to the other studies included.ResultsWhite patients had larger femoral AP measurements than East Asians (62 mm, [95% CI, 57–66 mm] vs 59 mm, [95% CI, 54–63 mm]; mean difference, 3 mm; p < 0.001), a smaller femoral aspect ratio than East Asians (1.20, [95% CI, 1.11–1.29] vs 1.25, [95% CI, 1.16–1.34]; mean difference, 0.05; p = 0.001), and a larger tibial aspect ratio than black patients (1.55, [95% CI, 1.40–1.71] vs 1.49, [95% CI, 1.33–1.64]; mean difference, 0.06; p = 0.005).ConclusionsThis analysis uncovered differences of size (AP height and ML width of the femur and tibia) and shape (tibial and femoral aspect ratios) among knees from white, East Asian, and black populations. Future research is needed to understand the clinical implications of these discrepancies and to provide additional data with underrepresented groups.

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Anthropometric Measurements of the Human Knee

Cited by 307 publications

References 5 publications

Statistical Shape Modeling of Skeletal Anatomy for Sex Discrimination: Their Training Size, Sexual Dimorphism, and Asymmetry

Statistical Shape Modeling of Skeletal Anatomy for Sex Discrimination: Their Training Size, Sexual Dimorphism, and Asymmetry

Morphological Measurements of the Normal Distal Femur and Proximal Tibia between Han Chinese and Mongolian Chinese in a Healthy Chinese Population

What Differences in Morphologic Features of the Knee Exist Among Patients of Various Races? A Systematic Review

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