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Chen S, Zheng Z, Guo J, Hong S, Zhou W, Xie J, Wang W. Five or more gender- and size-diverse customizations of distal femur prostheses are needed to improve fit for Chinese knees. Knee Surg Sports Traumatol Arthrosc 2023; 31:5388-5397. [PMID: 37750922 DOI: 10.1007/s00167-023-07580-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 09/05/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE Mismatch between partial imported prostheses and Chinese anatomy affects the clinical outcome of the procedure. The purpose of this study was to measure the anatomical dimensions of Chinese distal femurs to provide guidance for the design of more compatible distal femoral prostheses. METHODS A total of 406 healthy distal femurs were reconstructed and measured. Consistency of these measurements and differences in sides, gender, and populations were examined. Parameter correlations were analyzed, and pairs with strong correlations underwent linear regression analysis. The design of distal femoral prostheses was referenced from the results of K-means and hierarchical clustering analysis. RESULTS Ten parameters were measured, including the trans-epicondylar axis, width of the distal femur (ML), anteroposterior diameter of the distal femur (AP), etc. The intra-class correlation coefficient ranged from 0.795 to 0.999 for intra-observer consistency, and from 0.796 to 0.998 for inter-observer consistency. Males exhibited significantly larger parameters than females, except for the posterior condylar angle (all P values < 0.05). Compared to other populations, substantial differences were observed for most parameters, such as ML, AP, width of lateral femoral condyle, etc. (all P values < 0.05). Clustering analysis suggested that distal femoral prostheses should include at least five sizes to adequately accommodate the sampled population. ML sizes for males were 68, 70, 83, 73, and 89 mm, and for females 64, 65, 71, 67, and 77 mm. AP sizes for males were 56, 60, 60, 64, and 64 mm, and for females 48, 52, 54, 57, and 58 mm. CONCLUSIONS Chinese distal femur morphology, as analyzed using 3D techniques, varies significantly between genders and when compared with international data. For improved patient fit, the creation of five or more distal femur prostheses, diversified by gender and size and informed by the associated morphological parameters, is recommended. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Song Chen
- Department of Orthopedics, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, No.100, Minjiang Avenue, Quzhou, 324000, Zhejiang, China.
| | - Zhenxin Zheng
- Department of Orthopedics, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, No.100, Minjiang Avenue, Quzhou, 324000, Zhejiang, China
| | - Jinku Guo
- Department of Orthopedics, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, No.100, Minjiang Avenue, Quzhou, 324000, Zhejiang, China
| | - Shengkun Hong
- Department of Orthopedics, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, No.100, Minjiang Avenue, Quzhou, 324000, Zhejiang, China
| | - Weijun Zhou
- Department of Orthopedics, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, No.100, Minjiang Avenue, Quzhou, 324000, Zhejiang, China
| | - Jun Xie
- Department of Orthopedics, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, No.100, Minjiang Avenue, Quzhou, 324000, Zhejiang, China.
| | - Wei Wang
- Department of Orthopedics, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, No.100, Minjiang Avenue, Quzhou, 324000, Zhejiang, China.
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Dong XH, Huang XH, Chen M, Chang YH, Ling M, Yang B. Three-dimensional morphometric differences of resected distal femurs and proximal tibias in osteoarthritic and normal knees. BMC Musculoskelet Disord 2021; 22:1013. [PMID: 34863133 PMCID: PMC8645075 DOI: 10.1186/s12891-021-04889-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 11/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a paucity of data concerning the morphological differences of resected distal femurs and proximal tibias in osteoarthritic (OA) and normal knees. The objective of this study was to determine whether morphometric differences in the surfaces of resected distal femurs and proximal tibias exist between OA and normal knees in a Chinese population. METHODS Ninety-four OA knees and ninety-five normal knees were evaluated in Chinese individuals. Computed tomography was used to measure the femoral mediolateral (fML), medial anteroposterior (fMAP), lateral anteroposterior (fLAP), medial condylar width (fMCW), lateral condylar width (fLCW), medial posterior condylar curvature radii (fMCR), lateral posterior condyle curvature radii (fLCR), fML/fMAP aspect ratio, tibial mediolateral (tML), middle anteroposterior (tAP), medial anteroposterior (tMAP), and lateral anteroposterior (tLAP) tML/tMAP aspect ratio to determine the morphologic differences between OA and normal knees. RESULTS The average fMCW and tMAP dimensions of OA knees were larger than those of normal knees in both male and female (p <0.05). The fMAP/fML aspect ratio and tMAP/tML aspect ratio were also significantly different in both sexs (p <0.05). OA knees have an oval-shaped distal femur with a wider ML length and more spherical-shaped proximal tibiae with relatively narrow ML dimensions. CONCLUSIONS The study revealed the morphological differences in fMCW, tMAP, fMAP/fML and tMAP/tML between OA and normal knees in both males and females. These findings may provide guidelines that can be used to design better knee implants that are more size-matched for OA knees.
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Affiliation(s)
- Xiang-Hui Dong
- Department of Orthopaedics, Shaanxi Provincial People's Hospital (third affiliated hospital of Xi'an jiaotong University), No. 256, Youyi West Road, Xi'an, China.,Shaanxi Provincial Key Laboratory of Infection and Immune Diseases, Shaanxi Provincial People's Hospital (third affiliated hospital of Xi'an jiaotong University), No. 256, Youyi West Road, Xi'an, China
| | - Xiang-Hui Huang
- Department of Orthopaedics, Shaanxi Provincial People's Hospital (third affiliated hospital of Xi'an jiaotong University), No. 256, Youyi West Road, Xi'an, China
| | - Ming Chen
- Department of Orthopaedics, Shaanxi Provincial People's Hospital (third affiliated hospital of Xi'an jiaotong University), No. 256, Youyi West Road, Xi'an, China
| | - Yan-Hai Chang
- Department of Orthopaedics, Shaanxi Provincial People's Hospital (third affiliated hospital of Xi'an jiaotong University), No. 256, Youyi West Road, Xi'an, China
| | - Ming Ling
- Department of Orthopaedics, Shaanxi Provincial People's Hospital (third affiliated hospital of Xi'an jiaotong University), No. 256, Youyi West Road, Xi'an, China
| | - Bo Yang
- Department of Orthopaedics, Shaanxi Provincial People's Hospital (third affiliated hospital of Xi'an jiaotong University), No. 256, Youyi West Road, Xi'an, China.
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