Clinical Orthopaedics and Related Research

, Volume 466, Issue 12, pp 3059–3065

The Female Knee: Anatomic Variations and the Female-specific Total Knee Design


    • Department of Orthopaedic SurgeryStanford University School of Medicine
  • Elizabeth A. Arendt
    • Department of Orthopaedic SurgeryUniversity of Minnesota
  • Scott F. Dye
    • Department of Orthopaedic SurgeryUniversity of California San Francisco
  • Michael Fredericson
    • Department of Orthopaedic SurgeryStanford University School of Medicine
  • Ronald P. Grelsamer
    • Department of Orthopaedic SurgeryMount Sinai Medical School
  • Wayne B. Leadbetter
    • Center for Joint Preservation and ReplacementRubin Institute for Advanced Orthopaedics, Sinai Hospital
  • William R. Post
    • Mountaineer Orthopedic Specialists, LLC
  • Robert A. Teitge
    • Wayne State University

DOI: 10.1007/s11999-008-0536-5

Cite this article as:
Merchant, A.C., Arendt, E.A., Dye, S.F. et al. Clin Orthop Relat Res (2008) 466: 3059. doi:10.1007/s11999-008-0536-5


The concept and need for a gender-specific or female-specific total knee prosthesis have generated interest and discussion in the orthopaedic community and the general public. This concept relies on the assumption of a need for such a design and the opinion that there are major anatomic differences between male and female knees. Most of the information regarding this subject has been disseminated through print and Internet advertisements, and through direct-to-patient television and magazine promotions. These sources and a recent article in a peer-reviewed journal, which support the need for a female-specific implant design, have proposed three gender-based anatomic differences: (1) an increased Q angle, (2) less prominence of the anterior medial and anterior lateral femoral condyles, and (3) reduced medial-lateral to anterior-posterior femoral condylar aspect ratio. We examined the peer-reviewed literature to determine whether women have had worse results than men after traditional TKAs. We found women have equal or better results than men. In addition, we reviewed the evidence presented to support these three anatomic differences. We conclude the first two proposed differences do not exist, and the third is so small that it likely has no clinical effect.

Level of Evidence: Level IV, systematic review. See the Guidelines for Authors for a complete description of levels of evidence.

Copyright information

© The Association of Bone and Joint Surgeons 2008