Three dimensional morphometry of the knee to design the total knee arthroplasty for Chinese population

Cheng, Fu Bo; Ji, Xiao Feng; Y, Li; Feng, Jia; Zheng, Wen Xu; Sun, Yue Fang; Fu, Yao; Li, You Qiong

doi:10.1016/j.knee.2008.12.019

Cited by 160 publications

(232 citation statements)

References 17 publications

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“…The measurements are very high in Greek (Caucasian) population in male as well as females. [3] These measurements were almost similar to other populations of Asia [4,14] but higher than population of West Bengal [17] and Indonesia [2] . The medial condylar anteroposterior distance (MCAPD) in males was 57.49±2.34 mm while in females it was 53.91±2.05) which was significantly higher in male than female (p<0.01).…”

Section: Discussionsupporting

confidence: 80%

“…Most of the morphometric studies are done with measurement by radiographs, CT scans or magnetic resonance imaging techniques which are indirect methods [2,4,[10][11][12][13][14][15]. There are studies which suggest that indirect method of measurement are found inaccurate and not precise even though they are corrected by the projection method as well as by the resolutions.…”

Section: Discussionmentioning

confidence: 99%

“…Joint replacement has considered beneficial for removing pain and improve the lifestyle of patients in severe case of osteoarthritis [2]. Accurate morphometric anatomical data of the lower end of femur and gender morphometric differences are very important to make design of total knee joint replacement and internal fixation material [3,4]. Mismatch between Morphometric data and selected prosthesis may cause severe complications like anterior cruciate ligament rupture, soft tissue imbalance, decreased movements of knee and implant loosening.…”

Section: Introductionmentioning

confidence: 99%

“…Mismatch between Morphometric data and selected prosthesis may cause severe complications like anterior cruciate ligament rupture, soft tissue imbalance, decreased movements of knee and implant loosening. [3,[5][6][7][8][9] So knee prosthesis made based on morphometric data of components of knee (femur and tibia) and according to gender will give better results in early mobility as well as less complications [2,4]. Recent studies are based on difference between gender and ethnic groups.…”

Section: Introductionmentioning

confidence: 99%

“…Recent studies are based on difference between gender and ethnic groups. [3,4,[10][11][12][13] Most of the morphometric studies are done with measurement by radiographs, CT scans or Magnetic resonance imaging techniques [2,4,[10][11][12][13][14][15]. There are few data available in which the study is done over dry femur by direct observations [3,16,17].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Morphometric Study of Lower End of Dry Femur in Gujarat Region and Its Clinical Implication

Zalawadia¹,

Parekh²,

Patel³

2017

IJAR

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Morphometric Study of Lower End of Dry Femur in Gujarat Region and Its Clinical Implication

Zalawadia¹,

Parekh²,

Patel³

2017

IJAR

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Comprehensive assessment of tibial plateau morphology in total knee arthroplasty: Influence of shape and size on anthropometric variability

Dai¹,

Bischoff²

2013

Journal Orthopaedic Research

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Better understanding of proximal tibia morphology can lead to improvements in total knee arthroplasty (TKA) through development of tibial tray families that adequately reflect the diversity of global anatomy using an appropriate number of components. We quantified variations in proximal tibial morphology at the TKA level and characterized differences attributable to gender and ethnicity. Virtual TKA was performed on digital models of 347 tibiae, spanning both genders and multiple ethnicities. The geometry of the resection profile was quantified using both a comprehensive set of morphological measurements (reflecting size and shape) and principal component analysis (PCA). The dominant statistical modes of variation were associated primarily with size (plateau dimensions, radii, and area), with lesser contributions associated with asymmetry and aspect ratios. Medial and lateral AP dimensions were strongly correlated with plateau ML width, with minimal differences in correlations due to gender or ethnicity. In conclusion, clinically relevant differences in proximal tibia morphology at the level of TKA resections across genders and multiple ethnicities can be attributed largely to variations in overall proximal tibial size, not gender-or ethnic-specific shape variations. Keywords: anthropometry; TKA; principal component analysis Successful tibial component placement within total knee arthroplasty (TKA) entails accurate rotational alignment, 1,2 minimal overhang, 3,4 and good bone coverage, 5,6 each of which can be facilitated with tibial tray design that matches the resected proximal tibial surface. Several studies assessed knee morphology, focusing on qualitative description of overall bone morphology 7,8 or basic dimensional measurements [8][9][10][11][12][13] at the TKA level (such as anterior-posterior and medial-lateral dimensions). To fully characterize the asymmetric and irregular shape at the resection level, however, morphological quantification beyond qualitative or basic dimensional measurements is needed, with the potential to reveal ethnic-and gender-based morphological differences relevant to TKA design.Several studies associated ethnic morphological variability with differences in TKA clinical outcomes. Ho et al. 14 compared the morphology of Asian knees to TKA prostheses currently available in Asia. They concluded that contemporary prosthesis designs do not adequately capture the femoral aspect ratio of the Asian knee, resulting in mediolateral component overhang for Chinese patients. 14 Other anthropometric studies indicated considerable morphological differences in the knee between genders and ethnicities. 7,[11][12][13] However, due to the lack of a standardized methodology, the ability to combine results from multiple studies to make a broad assessment across ethnicities and genders is challenging.Several studies focusing specifically on proximal tibial morphology included both genders and multiple ethnicities in a single investigation. Yue et al. 11 reported that females are smaller ...

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Creation of a simple distal femur morphology classification system

Everhart

Chaudhari

Flanigan

2015

Journal Orthopaedic Research

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The purpose of this study is to propose a binary classification system based on simple measurements that summarizes individual, race, and sex-specific differences in distal femur shape. Surface models of 165 distal femurs (79 female, 86 male; 85 African-American, 80 Caucasian, 28.8 AE 7.6 years) were created with a 3-dimensional laser scanner. Surface area, width, length, curvature, and angulation were measured. Knees were classified as either type A or B within five distinct categories: (i) aspect ratio, (ii) trochlear-intercondylar width ratio, (iii) trochlear tilt, (iv) medial-lateral trochlear width ratio, and (v) trochlear sulcus shape. Correlations between these measures and surface area were calculated, and receiver-operator curves were used to select cutoff values between type A and B knees to improve differentiation of femur shapes by sex or race. The cutoff values between type A and B knees for the five categories are as follows: Category I: 0.90, Category II: 0.51, Category III: 1.02, Category IV: 0.67, and Category V: 128.7˚. Other than category IV (medial-lateral trochlear width ratio) (p ¼ 0.004, R ¼ 0.22), no categories were correlated with surface area (p > 0.25). Category I (aspect ratio, cutoff ¼ 0.90) best differentiated femurs by sex (p < 0.001, AUC ¼ 0.80), and Category V (sulcus shape) best differentiated femurs by race (p < 0.001, AUC ¼ 0.73). This system uses simple measurements to summarize important individual, race, and sex-specific differences in distal femur shape. It can be used in a clinical setting to provide insight into the relationship between sex or race differences in knee shape and mechanically influenced knee disorders ß 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:924-931, 2016.Keywords: distal femur morphology; anatomic classification system; gender differences; race differences; knee mechanicsThe shape of the distal femur is an important determinant of knee mechanics, and knee morphology is often implicated in the pathogenesis of knee disorders such as tibiofemoral osteoarthritis (OA) and patellofemoral disorders. Tibiofemoral OA pathogenesis and progression is significantly influenced by knee joint shape and alignment. [1][2][3][4][5][6][7] Regarding the tibiofemoral joint, condylar alignment is associated with knee OA and is an important factor in in femoral component positioning for total knee arthroplasty (TKA). [8][9][10] For the patellofemoral joint, trochlear shape and tilt have been associated with patellar maltracking 11 and resulting lateral patellofemoral instability, 12 chondromalacia, 13 and arthritis 14 with a clinical classification system for trochlear "dysplasia" presented by Dejour et al. 12,15 Several race or sex-specific anatomic factors are either associated with knee disorder pathogenesis or present implant design challenges for TKA. Women have a higher incidence of trochlear dysplasia and increased trochlear tilt; 14,16,17 additionally, women have a smaller average articular surface area 18 and n...

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Three dimensional morphometry of the knee to design the total knee arthroplasty for Chinese population

Cited by 160 publications

References 17 publications

Morphometric Study of Lower End of Dry Femur in Gujarat Region and Its Clinical Implication

Morphometric Study of Lower End of Dry Femur in Gujarat Region and Its Clinical Implication

Comprehensive assessment of tibial plateau morphology in total knee arthroplasty: Influence of shape and size on anthropometric variability

Creation of a simple distal femur morphology classification system

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