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Clinical Orthopaedics and Related Research®
Published in: Clinical Orthopaedics and Related Research® 1/2012

Open Access 01-01-2012 | Symposium: Papers Presented at the Annual Meetings of The Knee Society

Three-dimensional Morphology of the Knee Reveals Ethnic Differences

Authors: Mohamed Mahfouz, PhD, Emam ElHak Abdel Fatah, Bsc, Lyndsay Smith Bowers, MSc, Giles Scuderi, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 1/2012

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Abstract

Background

Studies have demonstrated sex differences in femoral shape and quadriceps angle raising a question of whether implant design should be sex-specific. Much of this research has addressed shape differences within the Caucasian population and little is known about differences among ethnic groups.

Questions/purposes

We therefore asked: Do shape differences in the distal femur and proximal tibia exist among different ethnic groups and between the sexes in each ethnic population? And if ethnic differences exist, do they have a clinical impact on current TKA design?

Subjects and Methods

We analyzed 1000 normal adult knees (80 African American, 80 East Asian, and 860 Caucasian). Three-dimensional surface models were created for each bone and added to three-dimensional statistical bone atlases. Statistical shape analysis was conducted with a process combining principal components and multiple discriminate analyses. Eleven femoral and nine tibial measurements were calculated.

Results

We found differences in mean measurements between the sexes and ethnicities. Males had larger knees, with a mean 5-mm-larger anteroposterior dimension than females in all ethnicities. African American females had a 7.4-mm-deeper patellar groove, 2.3-mm-smaller tibial mediolateral dimension, and 2.5-mm-larger tibial anteroposterior dimension than Caucasian females. African American males had a 4.3-mm-larger femoral anteroposterior dimension, 10.1-mm-larger tibial mediolateral dimension, and 6-mm-larger tibial anteroposterior dimension than Asian males.

Conclusions

We identified differences in three-dimensional knee morphology among Caucasian, African American, and East Asian populations. Clinical studies will be required to determine whether these differences are important for implant design.
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Metadata
Title
Three-dimensional Morphology of the Knee Reveals Ethnic Differences
Authors
Mohamed Mahfouz, PhD
Emam ElHak Abdel Fatah, Bsc
Lyndsay Smith Bowers, MSc
Giles Scuderi, MD
Publication date
01-01-2012
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 1/2012
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-011-2089-2

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