Vol. 20 No. 1 (2021)
Original Articles

Influence of gender and age on distal femur shape. Are there any relevant differences?

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  • Fabrício B. Loures,
  • Thales G. Felippe,
  • Matheus P. A. Góes,
  • Rogério F. A. Góes,
  • André Kinder,
  • Pedro José Labronici
Fabrício B. Loures
Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brazil.
Bio
Thales G. Felippe
Hospital Santa Teresa
Bio
Matheus P. A. Góes
Hospital Santa Teresa. Petrópolis, RJ, Brazil.
Bio
Rogério F. A. Góes
Serviço de Ortopedia, Hospital Santa Teresa. Petrópolis, RJ, Brazil.
André Kinder
Disciplina de Radiologia e Diagnóstico por Imagem, Faculdade de Medicina de Petrópolis. Petrópolis, RJ, Brazil.
Pedro José Labronici
Departamento de Cirurgia Especializada, Faculdade de Medicina, Universidade Federal Fluminense. Niterói, RJ, Brazil
DOI: https://doi.org/10.12957/bjhbs.2021.59742

Published 2021-07-03

Keywords

  • Anthropometry,
  • Arthroplasty,
  • Sex,
  • Knee,
  • Magnetic resonance

How to Cite

1.
Fabrício B. Loures, Thales G. Felippe, Matheus P. A. Góes, Rogério F. A. Góes, André Kinder, Pedro José Labronici. Influence of gender and age on distal femur shape. Are there any relevant differences?. BJHBS [Internet]. 2021 Jul. 3 [cited 2024 Oct. 11];20(1):19-26. Available from: https://bjhbs.hupe.uerj.br/bjhbs/article/view/50

Copyright (c) 2021 Brazilian Journal of Health and Biomedical Sciences

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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Abstract

Introduction: Osteoarthritis (OA) of the knee is a chronic, progressive, and highly prevalent disease. When the disease reaches its final stage, with clinical symptoms refractory to treatment or disabling deformity, surgical treatment becomes the option via total knee arthroplasty (TKA). The distal femur has a fundamental role in the success of TKA, being directly involved in joint stability, range of motion, and normal gait. Objective: Evaluate the possible sex differences in the shape of the distal femur and the age group influence on morphometry. Methods: Five measurements on 124 knees were evaluated using magnetic resonance imaging, 62 male and 62 female. The age ranged between 40 and 80 years, and the patients were divided into two age groups. Three factors were analyzed, allowing the bone classification regarding its width, shape, and symmetry. Results: The male group showed absolute measurements greater than the female, but there were no sex differences in the shape of the knee. Younger patients had more trapezoidal knees and a higher rate of asymmetry between condyles. After analyzing the factors, regarding their width, 31 knees were considered standard, 47 narrow, and 46 wide. As for the shape of the knee, 12 were considered standard, 58 rectangular, and 54 trapezoidal. About
the condyles symmetry, 23 were classified as symmetrical and 101 asymmetrical. There was a great interpersonal variation
in the shape of the knee, regardless of the sex. Conclusion: The shape of the distal femur presents great interpersonal variation, going beyond the simple division between wide or narrow. This variation is influenced by the patients’ age, but not the sex. Level of evidence: 4

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References

  1. Coimbra IB, Plaper PG, Campos GC. Generating evidence and understanding the treatment of osteoarthritis in Brazil. A study throught Delphi methodology. Clinics. 2019;74e722
  2. Murphy L, Helmick CG. The impact of osteoarthritis in the United States: a population-health perspective: A population-based review of the fourth most common cause of hospitalization in U.S. adults. Orthop Nurs. 2012;31(2):85-91.
  3. Schwechter EM, Fitz W. Design rationale for customized TKA: a new idea or revisiting the past? Curr Rev Musculoskelet Med 2012;5(4):303-8.
  4. Nguyen LC, Lehil MS, Bozic KJ. Trends in total knee arthroplasty implant utilization. J Arthroplasty. 2015;30(5):739-42.
  5. Sloan M, Premkumar A, Sheth NP. Projected volume of primary total joint arthroplasty in the US, 2014 to 2030. J Bone Joint Surg Am. 2018;100:1455-60.
  6. Ferreira MC, Oliveira JCP, Zidan FF, et al. Artroplastia total de joelho e quadril: a preocupante realidade assistencial do Sistema Único de Saúde brasileiro. Rev Bras Ortop. 2018;53(4):432-40.
  7. Gillespie RJ, Levine A, Fitzgerald SJ, et al. Gender differences in the anatomy of the distal femur. J Bone Joint Surg Br. 2011;93(3):357-63.
  8. Loures FB, de Araujo Goes RF, da Palma IM, et al. Anthropometric study of the knee and its correlation with the size of three implants available for arthroplasty. Rev Bras Ortop. 2016;51(3):282-9.
  9. Bonnin MP, Schmidt A, Basiglini L, Bossard N, Dantony E. Mediolateral oversizing influences pain, function, and flexion after TKA. Knee Surg Sports Traumatol Arthrosc. 2013;21(10):2314-24.
  10. Li K, Saffarini M, Valluy J, Desseroit MC, et al. Sexual and ethnic polymorphism render prosthetic overhang and undercoverage inevitable using off-the shelf TKA implants. Knee Surg Sports Traumatol Arthrosc. 2019;27(7):2130-9.
  11. Dargel J, Michael JW, Feiser J, et al. Human knee joint anatomy revisited: morphometry in the light of sex-specific total knee arthroplasty. J Arthroplasty. 2011;26(3):346-53.
  12. Triola MF. Introdução à Estatística. Rio de Janeiro: LTC; 2008.
  13. Kunze KN, Akram F, Fuller BC, et al. Internal Validation of a Predictive Model for Satisfaction After Primary Total Knee Arthroplasty. J Arthroplasty. 2019;34(4):663-70.
  14. Yang B, Yu J-K, Zheng Z-Z, et al. Comparative study of sex differences in distal femur morphology in osteoarthritic knees in a Chinese population. PLoS One. 2014;9(2):e89394.
  15. Bonnin MP, Saffarini M, Bossard N, et al. Morphometric analysis of the distal femur in total knee arthroplasty and native knees. Bone Joint J. 2016;98-B(1):49-57.
  16. Lonner JH, Jasko JG, Thomas BS. Anthropomorphic differences between the distal femora of men and women. Clin Orthop Relat Res. 2008;466:2724-9.
  17. Han H, Oh S, Chang CB, et al. Anthropometric difference of the knee on MRI according to gender and age groups. Surg Radiol Anat. 2016;38(2):203-11.
  18. Loures FB, Góes RFA, Sousa EB, et al. Intraoperative morphometric study of distal femur in Brazilian patients undergoing total knee arthroplasty. Plos One. 2020;15(5):e0233715.
  19. Li K, Cavaignac E, Xu W, et al. Morphometric evaluation of the knee in Chinese population reveals sexual dimorphism and age-related differences. Int Orthop. 2018;42(10):2349-56.
  20. Yao R, Lyons MC, Howard JL, et al. Does patellectomy jeopardize function after TKA? Clin Orthop Relat Res. 2013;471(2):544-53.
  21. Papalia R, Zampogna B, Torre G, et al. Sarcopenia and its relationship with osteoarthritis: risk factor or direct consequence? Musculoskelet Surg. 2014;98(1):9-14.
  22. Ha CW, Na SE. The correctness of fit of current total knee prostheses compared with intra-operative anthropometric measurements in Korean knees. J Bone Joint Surg Br. 2012;94(5):638-41.
  23. Kuo AW, Chen DB, Wood J, et al. Modern total knee arthroplasty designs do not reliably replicate anterior femoral morphology. Knee Surg Sports Traumatol Arthrosc. 2019;27 [Ahead of Print]
  24. Loures FB, Furtado Neto S, Pinto R de L, et al. Rotational assessment of distal femur and its relevance in total knee arthroplasty: analysis by magnetic resonance imaging. Radiol Bras. 2015;48(5):282-6. 26 bjhbs.hupe.uerj.br Original article
  25. Mahfouz M, Abdel Fatah EE, Bowers LS, et al. Threedimensional morphology of the knee reveals ethnic differences. Clin Orthop Relat Res. 2012;470(1):172-85.
  26. Pena SDJ. Reasons for banishing the concept of race from Brazilian medicine. Hist. Cienc Saude – Manguinhos. 2005;12(1):321-6.
  27. Piriou P, Mabit C, Bonnevialle P, et al. Are gender-specific femoral implants for total knee arthroplasty necessary? J Arthroplasty. 2014;29(4):742-8.
  28. Asseln M, Hänisch C, Schick F, et al. Gender differences in knee morphology and the prospects for implant design in total knee replacement. Knee. 2018;25(4):545-58
  29. Beal MD, Delagramaticas D, Fitz D. Improving outcomes in total knee arthroplasty-do navigation or customized implants have a role? J Orthop Surg Res. 2016;23:1
  30. Culler SD, Martin GM, Swearingen A. Comparison of adverse events rates and hospital cost between customized individually made implants and standard off-the-shelf implants for total knee arthroplasty. Arthroplasty Today. 2017;3(4):257-63.
  31. Loures FB, Carrara RJ, Góes RFA, et al. Anthropometric study of the knee in patients with osteoarthritis: intraoperative measurement versus magnetic resonance imaging. Radiol Bras. 2017;50(3):170-5.
  32. Cheng CK, Lung CY, Lee YM, et al. A new approach of designing the tibial baseplate of total knee prostheses. Clin Biomech (Bristol, Avon). 1999 Feb;14(2):112-7.
  33. Kwak D-S, Han S, Han CW, et al. Resected femoral anthropometry for design of the femoral component of the total knee prosthesis in a Korean population. Anat Cell Biol. 2010 Sep;43(3):252-9.