Wider femoral and mediolaterally narrower tibial components are required for total knee arthroplasty in Turkish patients
To evaluate the knee morphologic parameters in the Turkish population, compare them with known data, and identify new morphologic parameters.
Magnetic resonance (MR) images of 1000 healthy subjects aged 18–50 years were included. One orthopedic surgeon and one experienced musculoskeletal radiologist reviewed MR images and measured 22 morphologic parameters. Sex and side differences were evaluated. Correlations between age and measurement parameters were assessed. The measured parameters were compared with known data. Femoral and tibial condylar height differences were identified.
A strong correlation was found among regarding all measurement parameters (p = 0.000 and k > 0.985 for all measurements) by both observers. A significant difference between the female and male subjects regarding the measurement parameters (p = 0.000) was found, except for the tibial coronal slope, posterior condylar angle (PCA), medial and lateral tibial slopes (MTS and LTS), and medial plateau depth. No measurement parameter was significantly correlated with age (n.s.). The femur surface ratio in male and female subjects was 1.29 ± 1.04 and 1.28 ± 1.12, respectively (n.s.). The tibial plateau aspect ratio was 61.4 ± 1.09 in males and 59.8 ± 1.57 in females (p = 0.004). The mean medial and lateral femoral condylar cartilage and bone height differences were 3.3 ± 1.1 and 3.1 ± 0.9 mm, respectively. The mean medial and lateral tibial condylar cartilage and bone height differences were 2.3 ± 0.3 and 1.6 ± 0.1 mm, respectively.
Compared to current designs, wider femoral and mediolaterally narrower tibial components are needed to provide well-fitting prosthesis and improve functional outcomes, especially in women. The data on femoral and tibial condylar height differences will be useful for future research on component design. In the clinical practice, the components developed based on these findings will have a substantial effect on postoperative outcomes and patient satisfaction.
Level of evidence
KeywordsComponent Femoral surface ratio Height difference Tibial aspect ratio Anthropometry Total knee arthroplasty
This study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Compliance with ethical standards
Conflict of interest
Abdulhamit Misir, Kadir Ilker Yildiz, and Turan Bilge Kizkapan declare that they have no conflict of interest.
Metin Sabancı Baltalimanı Kemik Hastalıkları Eğitim ve Araştırma Hastanesi institutional review board approved the study protocol (Approval date/number 20.09.2017/15).
- 1.Berger RA, Rubash HE, Seel MJ, Thompson WH, Crossett LH (1993) Determining the rotational alignment of the femoral component in total knee arthroplasty using the epicondylar axis. Clin Orthop Relat Res 286:40–47Google Scholar
- 4.Fan L, Xu T, Li X, Zan P, Li G (2017) Morphologic features of the distal femur and tibia plateau in Southeastern Chinese population: a cross-sectional study. Medicine 96:1–5Google Scholar