Difference in coronal curvature of the medial and lateral femoral condyle morphology by gender in implant design for total knee arthroplasty.

Abstract

The purpose of this study was to investigate the morphometric data obtained from the three-dimensional magnetic resonance images of ethnic Korean knee osteoarthritis, and to evaluate the morphological differences between the coronal curvature of the female and male femoral condyles. The differences in coronal curvature of the femoral condyle morphology of 1990 patients (1689 females and 301 males) were evaluated in three dimensions. A close-fit diameter was, respectively, generated on the medial and lateral femoral condyle articular surfaces, and these diameters reflect the coronal diameter of the femoral condyle curvature. These measurements were compared with those of the femoral design of five different commonly used total knee arthroplasty (TKA) implant designs. The average diameter of the curvature of the medial condyles was significantly larger than that of the lateral condyles (P < 0.05). This trend was found in the male and female groups. In addition, the average diameter of the curvature of the femoral condyles was found to significantly differ between males and females (P < 0.05). For four TKA implant designs, the average diameter of the coronal curvature of femoral condyle was smaller than that obtained via our measurements, whereas one TKA implant design yielded a smaller average diameter. Furthermore, the medial and lateral coronal curvatures of the femoral condyle were symmetric in all TKA implant designs. The study provided a reliable and consistent evaluation of the coronal curvature of femoral condyles in the Korean population. These results showed that a gender-specific or asymmetric femoral component design is required to regenerate the coronal curvature of the femoral condyles for ethnically Korean males and females.