Are Western Knee Designs Dimensionally Correct for Korean Women? A Morphometric Study of Resected Femoral Surfaces during Primary Total Knee Arthroplasty

Kim, Jun-Bae; Lyu, Suk-Joo; Kang, Hyung Wook

doi:10.4055/cios.2016.8.3.254

Cited by 9 publications

(8 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This corroborates the findings of numerous studies that found women to have narrower knees [2, 19, 22, 25, 28, 39], though it is worth noting that some found no difference in aspect ratio between the sexes [27, 33]. Gender‐specific ‘narrow’ implants may thus alleviate some of the mediolateral overhang commonly reported in women [2, 21, 33], though they are not always sufficient to improve outcomes of TKA [11, 12, 37]. More recent studies also reported that Asians had wider knees than Caucasians [19, 22, 28], though others found no such difference [27, 39].…”

Section: Discussionsupporting

confidence: 88%

“…The present study was based on CT scans and reported multivariable analyses that control for confounding factors, while that of Mahfouz et al used magnetic resonance images, which can be less detailed when rendering bony structures, and presented basic univariable analyses, that do not control for confounding factors such as size. The present findings, therefore, affirm that Asian women have the highest asymmetry ratios, indicating once more, that this subgroup is the most likely to exhibit bone-implant mismatch [21,33].…”

Section: Discussionsupporting

confidence: 81%

See 1 more Smart Citation

Sexual and ethnic polymorphism render prosthetic overhang and under-coverage inevitable using off-the shelf TKA implants

Saffarini

Valluy

et al. 2019

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

Purpose Unexplained pain and stiffness after total knee arthroplasty (TKA) often result from mismatch between implant geometry and knee morphology, which depends on patient size, sex, and ethnicity. This study aimed to determine whether size, sex, or ethnicity are independently associated with distal femoral morphology in healthy Caucasian and Asian knees, and to compare anatomic ratios to those of commercially available TKA implants. Methods Two series of computed tomography (CT) angiograms from France (264 knees) and China (259 knees) were used to digitize osteometric landmarks at the level of the femoral epicondyles, to measure anteroposterior (AP) and mediolateral (ML) dimensions at the anterior, posterior, medial, and lateral zones. The aspect (ML/AP), trapezoidicity (MLp/MLa), and asymmetry (APl/APm) ratios, as well as the sulcus angle were calculated and compared to those of 9 TKA models. Multivariable analyses were performed to determine whether anatomic ratios were independently associated with sex, origin, or size. Results Multivariable analyses revealed that, independently from size, female knees were narrower (β = − 0.03; p < 0.001) and more asymmetric (β = 0.02; p < 0.001), while Chinese knees were more trapezoidal (β = 0.04; p = 0.002) and asymmetric (β = 0.02; p < 0.001) with shallower trochleae (β = 6.4°; p < 0.001). Compared to native knees, most implants were too wide, and many of the recent models too ‘trapezoidal’. Most prosthetic trochleae were too shallow compared to French knees, but within the third quartile of Chinese knees. Conclusions The morphology of the distal femur depends on sex and ethnicity independently from size. The wide spectrum of morphotypes observed cannot be covered by ‘off‐the‐shelf’ TKA models, and until customized implants become more accessible, prosthetic overhang, and under‐coverage remain inevitable. Level of evidence III, Retrospective comparative study.

show abstract

Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 81%

Sexual and ethnic polymorphism render prosthetic overhang and under-coverage inevitable using off-the shelf TKA implants

Saffarini

Valluy

et al. 2019

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

show abstract

“…After the completion of the experimental procedure, all participants underwent TKA with the same type of high-flexion mobile prosthesis (Implantcast; GMBH Lüneburger Schanze, Buxtehude, Germany) with cement using a tricompartmental, minimally invasive quadriceps-sparing technique [ 27 ].…”

Section: Methodsmentioning

confidence: 99%

Effects of Preoperative Telerehabilitation on Muscle Strength, Range of Motion, and Functional Outcomes in Candidates for Total Knee Arthroplasty: A Single-Blind Randomized Controlled Trial

Ryu²,

Lyu³

et al. 2021

IJERPH

Self Cite

View full text Add to dashboard Cite

This study aims to investigate the effect of a preoperative telerehabilitation (PT) program on muscle strength, knee range of motion (ROM), and functional outcomes in candidates for total knee arthroplasty (TKA). Sixty patients (all women, mean age 70.53 ± 2.7 years) scheduled for bilateral TKA participated in this study. The PT and preoperative patient education (PE) groups participated in a 3-week intensive exercise program (30 min/session, 2 times/day, 5 days/week), whereas the control group received the usual care before TKA. Quadriceps muscle strength, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), ROM of knee flexion, pain, and time up-and-go (TUG) test time were evaluated at 4 weeks preoperatively, post-interventionally, and 6 weeks after TKA. Significant differences were found in the time-by-group interaction for 60°/s extension peak torque [F(4, 100) = 2.499, p < 0.047, η2p = 0.91], 180°/s extension peak torque [F(4, 100) = 3.583, p < 0.009, η2p = 0.125], ROM [F(4, 100) = 4.689, p < 0.002, η2p = 0.158], TUG time [F(4, 100) = 7.252, p < 0.001, η2p = 0.225], WOMAC pain [F(4, 100) = 9.113, p < 0.001, η2p = 0.267], WOMAC functional outcome [F(4, 100) = 6.579, p < 0.001, η2p = 0.208], and WOMAC total score [F(4, 100) = 10.410, p < 0.001, η2p = 0.294]. The results of this study demonstrate the early benefits of a PT program in elderly female patients with end-stage osteoarthritis. The PT program improved muscle strength, ROM, and functional outcomes before TKA, which contributed to better functional recovery after TKA.

show abstract

“…36 This is further illustrated through the design of total knee arthroplasty, which is primarily designed for the White population anatomy, which is sufficiently different from that of the Korean population. 37 This provides additional credence to the notion that subanalysis of a patients demographics is integral when understanding the efficacy of new medical devices.…”

Section: Discussionmentioning

confidence: 91%

Diversity in Orthopaedic Surgery Medical Device Clinical Trials: An Analysis of the Food and Drug Administration Safety and Innovation Act

Issa

Lambrechts

Lin

et al. 2022

J Am Acad Orthop Surg

View full text Add to dashboard Cite

Introduction: Demographic factors contribute markedly to orthopaedic surgery outcomes. However, women and minorities have been historically excluded from clinical trials. The United States passed the Safety and Innovation Act (Food and Drug Administration Safety and Innovation Act [FDA-SIA]) in 2012 to increase study diversity and mandate reporting of certain demographics. The purpose of this study was to investigate demographic reporting and analysis among high-risk orthopaedic medical device trials and evaluate the effectiveness of the FDA-SIA in increasing diversity of study enrollment. Methods: The premarket approval database was queried for all original submissions approved by the Orthopedic Advisory Committee from January 1, 2003, to July 1, 2022. Study demographics were recorded. Weighted means of race, ethnicity, and sex were compared before and after FDA-SIA implementation with the US population. Results: We identified 51 orthopaedic trials with unique study data. Most Food and Drug Administration device trials reported age (98.0%) and sex (96.1%), but only 49.0% and 37.3% reported race and ethnicity, respectively. Only 23 studies analyzed sex, six analyzed race, and two analyzed ethnicity. Compared with the US population, participants were overwhelmingly White (91.36% vs. 61.63%, P , 0.001) with a significant underrepresentation of Black (3.65% vs. 12.41%, P = 0.008), Asian (0.86% vs. 4.8%, P = 0.030), and Hispanic participants (3.02% vs. 18.73%, P , 0.001) before 2013. The FDA-SIA increased female patient enrollment (58.99% vs. 47.96%, P = 0.021) but did not increase the enrollment of racial or ethnic minorities. Conclusion: Despite efforts to increase the generalizability of studies within the FDA-SIA, orthopaedic medical devices still fail to enroll

show abstract

Are Western Knee Designs Dimensionally Correct for Korean Women? A Morphometric Study of Resected Femoral Surfaces during Primary Total Knee Arthroplasty

Cited by 9 publications

References 25 publications

Sexual and ethnic polymorphism render prosthetic overhang and under-coverage inevitable using off-the shelf TKA implants

Sexual and ethnic polymorphism render prosthetic overhang and under-coverage inevitable using off-the shelf TKA implants

Effects of Preoperative Telerehabilitation on Muscle Strength, Range of Motion, and Functional Outcomes in Candidates for Total Knee Arthroplasty: A Single-Blind Randomized Controlled Trial

Diversity in Orthopaedic Surgery Medical Device Clinical Trials: An Analysis of the Food and Drug Administration Safety and Innovation Act

Contact Info

Product

Resources

About