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The John Insall Award: Both Morphotype and Gender Influence the Shape of the Knee in Patients Undergoing TKA

  • Symposium: Papers Presented at the Annual Meetings of the Knee Society
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

There is an ongoing debate whether gender differences in the dimensions of the knee should influence the design of TKA components. We hypothesized that not only gender but also the patient’s morphotype determined the shape of the distal femur and proximal tibia and that this factor should be taken into account when designing gender-specific TKA implants. We reviewed all 1000 European white patients undergoing TKA between April 2003 and June 2007 and stratified each into one of three groups based on their anatomic constitution: endomorph, ectomorph, or mesomorph. Of the 250 smallest knees, 98% were female, whereas 81% of the 250 largest knees were male. In the group with intermediate-sized knees, female knees were narrower than male knees. Patients with smaller knees (predominantly female) demonstrated large variability between narrow and wide mediolateral dimensions irrespective of gender. The same was true for larger knees (predominantly male). This variability within gender could partially be explained by morphotypic variation. Patients with short and wide morphotype (endomorph) had, irrespective of gender, wider knees, whereas patients with long and narrow morphotype (ectomorph) had narrower knees. The shape of the knee is therefore not only dependent on gender, but also on the morphotype of the patient.

Level of Evidence: Level I, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Steffen Fieuws and his coworkers from the Biostatistical Centre of the School of Public Health of the Catholic University Leuven for the statistical analysis.

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Authors and Affiliations

  1. University Hospitals of the Catholic University, Leuven, Belgium

    Johan Bellemans MD, PhD, Karel Carpentier MD, Hilde Vandenneucker MD, Johan Vanlauwe MD & Jan Victor MD

  2. Department of Orthopaedic Surgery, University Hospital Pellenberg, Weligerveld 1, 3012, Pellenberg, Belgium

    Johan Bellemans MD, PhD

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  1. Johan Bellemans MD, PhD
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  2. Karel Carpentier MD
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  3. Hilde Vandenneucker MD
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  4. Johan Vanlauwe MD
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  5. Jan Victor MD
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Correspondence to Johan Bellemans MD, PhD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Bellemans, J., Carpentier, K., Vandenneucker, H. et al. The John Insall Award: Both Morphotype and Gender Influence the Shape of the Knee in Patients Undergoing TKA. Clin Orthop Relat Res 468, 29–36 (2010). https://doi.org/10.1007/s11999-009-1016-2

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  • DOI: https://doi.org/10.1007/s11999-009-1016-2

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