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Sex differences in femoral deformity determined using three-dimensional assessment for osteoarthritic knees

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To characterize femoral deformities and determine sex differences in varus knee osteoarthritis (OA), femoral morphology and limb alignment were evaluated by using three-dimensional (3D) assessment, comparing healthy, elderly volunteers with osteoarthritic knees.

Methods

A total of 178 lower limbs of 169 subjects with knee osteoarthritis (136 women, 33 men; mean age 74.9 ± 5.2 years) and 80 lower limbs of 45 healthy, elderly subjects (24 women, 21 men; mean age 65 ± 4.9 years) were examined. A 3D extremity alignment assessment system was used to examine the subjects under weight-bearing conditions on biplanar long-leg radiographs using a 3D-to-2D image registration technique. The evaluation parameters were (1) femoral bowing in the coronal plane, (2) femoral bowing in the sagittal plane, (3) femoral neck anteversion, (4) hip–knee–ankle angle, and (5) femoral torsion.

Results

Higher femoral lateral bowing and slightly higher femoral internal torsion in the proximal diaphysis were observed in women with OA compared with healthy subjects. No difference in the higher varus malalignment, no alteration in the femoral anterior bowing, and no difference in the lower femoral neck anteversion were found between men and women when comparing healthy and OA subjects.

Conclusions

The higher femoral lateral bowing and slightly higher femoral internal torsion in the proximal diaphysis in women are possibly a structural adaptation to mechanical use. The clinical significance is that the femoral deformities and the sex differences in knee OA have the potential to improve the understanding of the aetiology of primary varus knee OA.

Level of evidence

IV.

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Acknowledgments

This study would have been impossible without the cooperation of the Department of Radiology, Niigata Medical Center and Niigata University Hospital. The authors would like to thank all staff members of the department. The authors would also like to thank all staff members of LEXI Corporation, Tokyo, Japan, for their technical support.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University, Graduate School of Medical and Dental Science, 1-757 Asahimachi-dori Chuo-ku, Niigata, Niigata, 951-8510, Japan

    Tomoharu Mochizuki, Osamu Tanifuji & Naoto Endo

  2. Department of Orthopaedic Surgery, Nioji Onsen Hospital, Niigata, Japan

    Yoshio Koga

  3. Department of Orthopaedic Surgery, Niigata Medical Center, Niigata, Japan

    Takashi Sato & Satoshi Watanabe

  4. Department of Health Sciences, Niigata University, School of Medicine, Niigata, Japan

    Koichi Kobayashi

  5. Niigata Institute for Health and Sports Medicine, Niigata, Japan

    Katsutoshi Nishino

  6. Department of Orthopaedic Surgery, Nagaoka Chuo General Hospital, Niigata, Japan

    Akihiro Ariumi

  7. Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA

    Toshihide Fujii

  8. Department of Orthopaedic Surgery, Saiseikai Niigata Daini Hospital, Niigata, Japan

    Hiroshi Yamagiwa

  9. Department of Health and Sports, Faculty of Health Sciences, Niigata University of Health and Welfare, Niigata, Japan

    Go Omori

Authors
  1. Tomoharu Mochizuki
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  2. Osamu Tanifuji
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  3. Yoshio Koga
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  4. Takashi Sato
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  5. Koichi Kobayashi
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  6. Katsutoshi Nishino
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  7. Satoshi Watanabe
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  8. Akihiro Ariumi
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  9. Toshihide Fujii
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  10. Hiroshi Yamagiwa
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  11. Go Omori
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  12. Naoto Endo
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Corresponding author

Correspondence to Tomoharu Mochizuki.

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The authors did not receive and will not receive any benefits or funding from any commercial party related directly or indirectly to the subject of this article.

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Mochizuki, T., Tanifuji, O., Koga, Y. et al. Sex differences in femoral deformity determined using three-dimensional assessment for osteoarthritic knees. Knee Surg Sports Traumatol Arthrosc 25, 468–476 (2017). https://doi.org/10.1007/s00167-016-4166-2

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  • DOI: https://doi.org/10.1007/s00167-016-4166-2

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