Clin Orthop Surg.  2016 Sep;8(3):254-261. 10.4055/cios.2016.8.3.254.

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

• Kim JB
• Lyu SJ
• Kang HW

• KMID: 2374270
• DOI: http://doi.org/10.4055/cios.2016.8.3.254

Abstract

BACKGROUND
The purpose of this study was to determine the shape of the distal femur of Korean women compared with the prostheses currently available in Korea.
METHODS
Morphometric data (5 parameters) were measured in 356 resected femurs of Korean women undergoing primary total knee arthroplasty (TKA) utilizing the LCS knee implant (DePuy). The data were then compared with 5 additional contemporary TKA implant systems.
RESULTS
Implant designs based on Caucasian population data do not ideally match the distal femoral morphology of Korean women. Overhang at the anterior mediolateral width was observed in 84.8% for the LCS while a gender-specific implant resulted in undercoverage of the bone in 86%. Posterior overhang was observed in up to 51.2%. Most implant designs have a narrower intercondylar notch than the morphologic data of Korean women.
CONCLUSIONS
Since there is some difference between the shape of distal femur of Korean women and that of the implants, surgeons should have this in mind when selecting an implant for a patient. These data may also be used as a guideline for future prosthetic design options for Korean women population.

Keyword

Morphometry; Femur; Korean; Total knee arthroplasty

MeSH Terms

Aged
Aged, 80 and over
Arthroplasty, Replacement, Knee/*instrumentation/statistics & numerical data
Asian Continental Ancestry Group/*statistics & numerical data
Cohort Studies
Female
Femur/*anatomy & histology/*surgery
Humans
Knee Joint/surgery
Middle Aged
Prosthesis Design
Republic of Korea

Figure

• 

  Fig. 1 Visualization of the definition of each measured dimension after distal femoral bone cut. (A) The anterior mediolateral (AML), posterior mediolateral (PML), and intercondylar notch (IC) were measured with a caliper. (B) Medial posterior condyle (MPC) and lateral posterior condyle (LPC) length dimensions were obtained using a depth gauge.

• 

  Fig. 2 Measured anterior mediolateral (AML, A) and posterior mediolateral (PML, B) data plotted against the LCS (DePuy) anteroposterior (AP) size along with the available AP sizes of the other 5 knee implants studied including PFC Sigma (DePuy Synthes), NexGen LPS (Zimmer), NexGen LPS Gender (Zimmer), Triathlon (Stryker), and ACS Hyperflex (Implantcast).

• 

  Fig. 3 Intraoperative picture showing the overhang of an LCS (DePuy) implant beyond the resected surface of the distal femur at the anterior mediolateral site.

• 

  Fig. 4 The anterior mediolateral (AML) / posterior mediolateral (PML) ratio (AML width / PML width × 100) was calculated and plotted against the anteroposterior (AP) size of all implants including LCS (DePuy), PFC Sigma (DePuy Synthes), NexGen LPS (Zimmer), NexGen LPS Gender (Zimmer), Triathlon (Stryker), and ACS Hyperflex (Implantcast).

• 

  Fig. 5 Measured lateral posterior condyle (A) and medial posterior condyle (B) data plotted against the LCS (DePuy) anteroposterior (AP) size along with the available AP sizes of the other 5 knee implants studied including PFC Sigma (DePuy Synthes), NexGen LPS (Zimmer), NexGen LPS Gender (Zimmer), Triathlon (Stryker), and ACS Hyperflex (Implantcast).

• 

  Fig. 6 Postoperative radiograph (A) and line drawing (B) showing posterior condylar overhang of the LCS prosthesis (DePuy).

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  Fig. 7 Measured intercondylar data plotted against the LCS (DePuy) anteroposterior (AP) size along with the available AP sizes of the other 5 knee implants studied including PFC Sigma (DePuy Synthes), NexGen LPS (Zimmer), NexGen LPS Gender (Zimmer), Triathlon (Stryker), and ACS Hyperflex (Implantcast).

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