The Shape and Size of Femoral Components in Revision Total Hip Arthroplasty among Chinese Patients

Chiu, Kwong Yuen; Ng, T P; Tang, W.M.; Cheng, Hang; Hung, T S L; Tse, P Y T; Ko, P.S.

doi:10.1177/230949900301100112

Cited by 13 publications

(9 citation statements)

References 8 publications

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“…Ethnic differences have not received much focus given that most research has been aimed at the investigation of shape differences within the Caucasian population [2–4, 6, 10, 11, 17, 21–23]; however, previous studies have reported the anatomy and comparison of East Asian populations (Japanese, Chinese, Indian) to existing implant systems [3, 4, 10, 11, 21–23, 26]. We therefore asked: (1) Do shape differences in the distal femur and proximal tibia exist among different ethnic groups?…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have reported the anatomy and comparison of East Asian populations (Japanese, Chinese, Indian) to existing implant systems [3, 4, 10, 11, 21–23, 26]. Anatomic differences have been identified between both sex and ethnicity, with Caucasian subjects having a higher tibial torsion angle and lower varus alignment than Japanese [12].…”

Section: Introductionmentioning

confidence: 99%

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Three-dimensional Morphology of the Knee Reveals Ethnic Differences

Mahfouz

Fatah

Bowers

et al. 2012

Clinical Orthopaedics &Amp; Related Research

185

173

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BackgroundStudies have demonstrated sex differences in femoral shape and quadriceps angle raising a question of whether implant design should be sex-specific. Much of this research has addressed shape differences within the Caucasian population and little is known about differences among ethnic groups.Questions/purposesWe therefore asked: Do shape differences in the distal femur and proximal tibia exist among different ethnic groups and between the sexes in each ethnic population? And if ethnic differences exist, do they have a clinical impact on current TKA design?Subjects and MethodsWe analyzed 1000 normal adult knees (80 African American, 80 East Asian, and 860 Caucasian). Three-dimensional surface models were created for each bone and added to three-dimensional statistical bone atlases. Statistical shape analysis was conducted with a process combining principal components and multiple discriminate analyses. Eleven femoral and nine tibial measurements were calculated.ResultsWe found differences in mean measurements between the sexes and ethnicities. Males had larger knees, with a mean 5-mm-larger anteroposterior dimension than females in all ethnicities. African American females had a 7.4-mm-deeper patellar groove, 2.3-mm-smaller tibial mediolateral dimension, and 2.5-mm-larger tibial anteroposterior dimension than Caucasian females. African American males had a 4.3-mm-larger femoral anteroposterior dimension, 10.1-mm-larger tibial mediolateral dimension, and 6-mm-larger tibial anteroposterior dimension than Asian males.ConclusionsWe identified differences in three-dimensional knee morphology among Caucasian, African American, and East Asian populations. Clinical studies will be required to determine whether these differences are important for implant design.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Three-dimensional Morphology of the Knee Reveals Ethnic Differences

Mahfouz

Fatah

Bowers

et al. 2012

Clinical Orthopaedics &Amp; Related Research

185

173

View full text Add to dashboard Cite

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“…Other authors reported that significant anterior cortical thinning ( Figure 4) was more common in Chinese patients if 200-mm straight stems were used and suggested using bowed 200-mm femoral components instead. 26 Onlay structural bone graft is augmented for supporting thinning cortex or intraoperative perforation. Emerson et al 27 reported that onlay graft united in an average of 8.4 months through a healing process with round-off, followed by partial and complete bridging.…”

Section: Discussionmentioning

confidence: 99%

Extensively Porous-coated Stems for Femoral Revision: Reliable Choice for Stem Revision in Paprosky Femoral Type III Defects

Chung¹,

Wu²,

Chen³

et al. 2012

Orthopedics

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Between January 1999 and August 2008, ninety-six femoral revisions were performed with extensively porous-coated stems in Paprosky type III femoral defects (89 type IIIA and 7 type IIIB defects). Seven type IIIB defects with a mean canal of 16.5 mm were observed; 6 defects achieved stable bone ingrowth and 1 achieved stable fibrous condition. Average postoperative Harris Hip Score was 92.3±8 (range, 77-100), and all scores improved postoperatively. At a mean follow-up of 65.7 months, 92 stems achieved bone ingrowth, and 1 stem (type IIIB) achieved a stable fibrous condition. Three patients died from causes unrelated to the surgery during follow-up. The most frequent diagnosis for revision of the femoral component was loosening of the cementless stem (53 patients; 55.2%), followed by status after a Girdlestone procedure (21 patients; 21.8%), after total hip arthroplasty with acetabular wear (10 patients; 10.4%), loosening of the cemented stem (7 patients; 7.3%), and periprosthetic fracture (5 patients; 5.2%). The authors performed 65 total hip arthroplasty revisions, 23 femoral component revisions, and 8 revisions of femoral components with cemented liners in patients with well-fixed acetabular shells. Extensively porous-coated stems in femoral revision for Paprosky type III femoral defects provided good mid-term durability.

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“…5 Another Chinese study also highlighted the need of smaller sized femoral component for Chinese population. 6 The study in 337 knees have compared the aspect ratio in males and females, found that higher aspect ratio for femur and tibia in smaller size knees, mainly in females. 7 Mahfouz M et al has published a three-dimensional morphology data of 1000 knees comparing African Americans, East Asians and Caucasians.…”

Section: Introductionmentioning

confidence: 99%