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Gender differences in morphology exist in posterior condylar offsets of the knee in Korean population

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study aimed to analyze the morphometric data from magnetic resonance images of arthritic knees in Korean adults, and to identify the existence of morphological differences of femoral posterior condylar offset (PCO) between genders.

Methods

The differences in anthropometric PCO data in 975 patients (825 female and 150 male) were evaluated. The distances from the anterior and posterior femoral shaft cortex line to the most posterior femoral condyle tangent line were defined as the anterior–posterior dimension (AP) and the PCO. The PCO ratio (PCOR) was calculated as PCO/AP.

Results

The medial PCO was greater than the lateral PCO (26.3 ± 2.2 vs. 24.3 ± 2.3 mm, p < 0.01). This difference was observed in both female patients (medial: 26.2 ± 2.2 mm vs. lateral: 24.2 ± 2.2 mm, p < 0.01) and male patients (medial: 26.8 ± 2.3 mm vs. lateral: 24.8 ± 2.4 mm, p < 0.01). The medial and lateral PCO values were also greater in male patients than in female ones (p < 0.01). In contrast, PCOR was greater in female patients than in male ones, both in the medial and lateral femoral condyles (p < 0.01).

Conclusions

It was shown that medial and lateral PCO and PCOR were asymmetric, and that there was gender difference in Korean population in our study. In addition, our data showed that the PCOR of contemporary TKAs may be small for Asian patients that may not be sufficient to meet the needs of the Korean patient population. These results confirm that a gender-specific femoral component design is necessary to recreate the PCO for male and female Asian populations.

Level of evidence

Non-consecutive patients, Level III.

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References

  1. Barnes CL, Iwaki H, Minoda Y, Green JM IInd, Obert RM (2010) Analysis of sex and race and the size and shape of the distal femur using virtual surgery and archived computed tomography images. J Surg Orthop Adv 19:200–208

    PubMed  Google Scholar 

  2. Bellemans J, Banks S, Victor J, Vandenneucker H, Moemans A (2002) Fluoroscopic analysis of the kinematics of deep flexion in total knee arthroplasty. Influence of posterior condylar offset. J Bone Jt Surg Br 84:50–53

    Article  CAS  Google Scholar 

  3. Cinotti G, Sessa P, Ripani FR, Postacchini R, Masciangelo R, Giannicola G (2012) Correlation between posterior offset of femoral condyles and sagittal slope of the tibial plateau. J Anat 221:452–458

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Clarke HD, Scott WN, Insall JN (2001) Anatomy. In: Insall JN, Scott WN (eds) Surgery of the knee, 1, 3rd edn. Churchill Livingstone, New York, p 13

    Google Scholar 

  5. Clement ND, Hamilton DF, Burnett R (2014) A technique of predicting radiographic joint line and posterior femoral condylar offset of the knee. Arthritis 2014:121069

    Article  PubMed  PubMed Central  Google Scholar 

  6. Han H, Oh S, Chang CB, Kang SB (2016) Anthropometric difference of the knee on MRI according to gender and age groups. Surg Radiol Anat 38:203–211

    Article  PubMed  Google Scholar 

  7. Han H, Oh S, Chang CB, Kang SB (2016) Changes in femoral posterior condylar offset and knee flexion after PCL-substituting total knee arthroplasty: comparison of anterior and posterior referencing systems. Knee Surg Sports Traumatol Arthrosc 24:2483–2488

    Article  PubMed  Google Scholar 

  8. Hanratty BM, Thompson NW, Wilson RK, Beverland DE (2007) The influence of posterior condylar offset on knee flexion after total knee replacement using a cruciate-sacrificing mobile-bearing implant. J Bone Jt Surg Br 89:915–918

    Article  CAS  Google Scholar 

  9. Ishii Y, Noguchi H, Takeda M, Ishii H, Toyabe S (2011) Changes in the medial and lateral posterior condylar offset in total knee arthroplasty. J Arthroplasty 26:255–259

    Article  PubMed  Google Scholar 

  10. Johal P, Hassaballa MA, Eldridge JD, Porteous AJ (2012) The posterior condylar offset ratio. Knee 19:843–845

    Article  PubMed  Google Scholar 

  11. Kamath AF, Horneff JG, Gaffney V, Israelite CL, Nelson CL (2010) Ethnic and gender differences in the functional disparities after primary total knee arthroplasty. Clin Orthop Relat Res 468:3355–3361

    Article  PubMed  PubMed Central  Google Scholar 

  12. Kang KT, Kim SH, Son J, Lee YH, Kim S, Chun HJ (2017) Probabilistic evaluation of the material properties of the in vivo subject-specific articular surface using a computational model. J Biomed Mater Res B Appl Biomater 105:1390–1400

    Article  CAS  PubMed  Google Scholar 

  13. Kang KT, Koh YG, Son J, Kwon OR, Lee JS, Kwon SK (2018) A computational simulation study to determine the biomechanical influence of posterior condylar offset and tibial slope in cruciate retaining total knee arthroplasty. Bone Jt Res 7:69–78

    Article  Google Scholar 

  14. Kang KT, Son J, Kwon OR, Baek C, Heo DB, Park KM, Kim HJ, Koh YG (2016) Morphometry of femoral rotation for total knee prosthesis according to gender in a Korean population using three-dimensional magnetic resonance imaging. Knee 23:975–980

    Article  PubMed  Google Scholar 

  15. Kang KT, Son J, Kwon OR, Baek C, Heo DB, Park KM, Kim HJ, Koh YG (2017) Effects of measurement methods for tibial rotation axis on the morphometry in Korean populations by gender. Knee 24:23–30

    Article  PubMed  Google Scholar 

  16. Kapoor A, Mishra SK, Dewangan SK, Mody BS (2008) Range of movements of lower limb joints in cross-legged sitting posture. J Arthroplasty 23:451–453

    Article  PubMed  Google Scholar 

  17. Kim YH, Sohn KS, Kim JS (2005) Range of motion of standard and high-flexion posterior stabilized total knee prostheses. A prospective, randomized study. J Bone Jt Surg Am 87:1470–1475

    Article  Google Scholar 

  18. Li G, Suggs J, Hanson G, Durbhakula S, Johnson T, Freiberg A (2006) Three-dimensional tibiofemoral articular contact kinematics of a cruciate-retaining total knee arthroplasty. J Bone Jt Surg Am 88:395–402

    Article  Google Scholar 

  19. Li K, Langdale E, Tashman S, Harner C, Zhang X (2012) Gender and condylar differences in distal femur morphometry clarified by automated computer analyses. J Orthop Res 30:686–692

    Article  PubMed  Google Scholar 

  20. Ma QL, Lipman JD, Cheng CK, Wang XN, Zhang YY, You B (2017) A comparison between Chinese and Caucasian 3-dimensional bony morphometry in presimulated and postsimulated osteotomy for total knee arthroplasty. J Arthroplasty 32:2878–2886

    Article  PubMed  Google Scholar 

  21. Mahfouz M, Abdel Fatah EE, Bowers LS, Scuderi G (2012) Three-dimensional morphology of the knee reveals ethnic differences. Clin Orthop Relat Res 470:172–185

    Article  PubMed  Google Scholar 

  22. Massin P, Gournay A (2006) Optimization of the posterior condylar offset, tibial slope, and condylar roll-back in total knee arthroplasty. J Arthroplasty 21:889–896

    Article  PubMed  Google Scholar 

  23. Nunley RM, Ellison BS, Zhu J, Ruh EL, Howell SM, Barrack RL (2012) Do patient-specific guides improve coronal alignment in total knee arthroplasty? Clin Orthop Relat Res 470:895–902

    Article  PubMed  Google Scholar 

  24. Onodera T, Majima T, Nishiike O, Kasahara Y, Takahashi D (2013) Posterior femoral condylar offset after total knee replacement in the risk of knee flexion contracture. J Arthroplasty 28:1112–1116

    Article  PubMed  Google Scholar 

  25. Tashiro Y, Uemura M, Matsuda S, Okazaki K, Kawahara S, Hashizume M, Iwamoto Y (2012) Articular cartilage of the posterior condyle can affect rotational alignment in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 20:1463–1469

    Article  PubMed  Google Scholar 

  26. Terzidis I, Totlis T, Papathanasiou E, Sideridis A, Vlasis K, Natsis K (2012) Gender and side-to-side differences of femoral condyles morphology: osteometric data from 360 Caucasian dried femori. Anat Res Int 2012:679658

    PubMed  PubMed Central  Google Scholar 

  27. Voleti PB, Stephenson JW, Lotke PA, Lee GC (2014) Plain radiographs underestimate the asymmetry of the posterior condylar offset of the knee compared with MRI. Clin Orthop Relat Res 472:155–161

    Article  PubMed  Google Scholar 

  28. Voleti PB, Stephenson JW, Lotke PA, Lee GC (2015) No sex differences exist in posterior condylar offsets of the knee. Clin Orthop Relat Res 473:1425–1431

    Article  PubMed  Google Scholar 

  29. Wang W, Tsai TY, Yue B, Kwon YM, Li G (2014) Posterior femoral condylar offsets of a Chinese population. Knee 21:553–556

    Article  PubMed  Google Scholar 

  30. Weinberg DS, Streit JJ, Gebhart JJ, Williamson DF, Goldberg VM (2015) Important differences exist in posterior condylar offsets in an osteological collection of 1,058 femurs. J Arthroplasty 30:1434–1438

    Article  PubMed  Google Scholar 

  31. Wernecke GC, Seeto BG, Chen DB, MacDessi SJ (2016) Posterior condylar cartilage thickness and posterior condylar offset of the femur: a magnetic resonance imaging study. J Orthop Surg (Hong Kong) 24:12–15

    Article  CAS  Google Scholar 

  32. Yazar F, Imre N, Battal B, Bilgic S, Tayfun C (2012) Is there any relation between distal parameters of the femur and its height and width? Surg Radiol Anat 34:125–132

    Article  PubMed  Google Scholar 

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Funding

There was no funding for this study.

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Author notes

  1. Yong-Gon Koh and Ji-Hoon Nam contributed equally to this work and should be considered co-first authors.

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Joint Reconstruction Center, Yonsei Sarang Hospital, 10 Hyoryeong-ro, Seocho-gu, Seoul, 06698, Republic of Korea

    Yong-Gon Koh & Hyun-Seok Chung

  2. Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea

    Ji-Hoon Nam, Heoung-Jae Chun & Kyoung-Tak Kang

  3. Spine Center, Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea

    Ho-Joong Kim

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  1. Yong-Gon Koh
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Correspondence to Kyoung-Tak Kang.

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The authors declare no conflict of interest.

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Approval was not required, as neither human participants nor animals were involved in this study.

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Koh, YG., Nam, JH., Chung, HS. et al. Gender differences in morphology exist in posterior condylar offsets of the knee in Korean population. Knee Surg Sports Traumatol Arthrosc 27, 1628–1634 (2019). https://doi.org/10.1007/s00167-018-5259-x

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  • DOI: https://doi.org/10.1007/s00167-018-5259-x

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