Abstract
Total Knee replacement (TKR) is performed to relieve pain and restore both the mechanical axis and joint line whenever indicated. Most of prostheses being used for TKR were manufactured using dimensions from Caucasians' measurements. This study documented the dimensions of distal femora of Nigerians and correlated the dimensions with different TKR prostheses. Fifty-six matured femora were measured. Dimensions of distal femora from other regions were retrieved from published articles. The dimensions of TKR prosthesis were extracted from product monographs. Analyses were done with Microsoft excel 2010 (Microsoft Corporation, Redmond, Washington, United States) and STATA version 13 (StataCorp, Texas. USA). Statistical significance was set at p ≤ 0.05. The average Mediolateral dimension was 79.3 ± 4.4 mm. The anterioposterior dimensions of the medial and lateral condyles were 63.7 ± 3.6 mm and 64.9 ± 3.3 mm respectively. There were no significant differences between the left and right distal femur. The average aspect ratio calculated was1.23 ± 0.05. There was a mismatch of aspect ratio of the distal femora and those of the prostheses. Equations that can be useful both clinically and in forensic medicine were generated. This study has provided measurements that can be considered when the designing of a suitable femoral component of total knee prosthesis for Nigerians. This study also provided equations that can be used to estimate the dimensions of the medial and the lateral condyles and femoral length from parts of distal femur in forensic medicine. Self-funded.
Highlights
Total knee replacement (TKR) surgery has become a worldwide procedure, performed on patients with chronic moderate to severe pain that is refractory to all non-surgical modalities.[1,2]
Regression analysis revealed significant statistical relationships between the lengths of the femur and parts that made up the distal femur. (Figure 4 & 5) There were significant statistical relationships between different parts that made up the distal femur
The trend lines of the femoral prostheses had steep slopes compare to the trend line of the femoral condyles with gentle positive slope
Summary
Total knee replacement (TKR) surgery has become a worldwide procedure, performed on patients with chronic moderate to severe pain that is refractory to all non-surgical modalities.[1,2] This procedure restores both the mechanical axis and joint line of the affected limb.[3] Indications for Total Knee Replacement includes osteoarthritis , rheumatoid arthritis, spondyloarthropathies, ankylosing spondylitis, psoriatic arthropathy, and posttraumatic arthritis secondary to intra-articular fracture.[1,2] During this procedure, total knee Prostheses (comprising femoral and tibial components) are used to replace the degenerated ends of the articulating bones which are cut off Most of these prostheses were manufactured using dimensions from Caucasian femora and tibiae osteometric measurements. Thilak et al[4], in their study amongst Indian patients, documented that all the implants used in their study showed some amount of mismatch with patients’ anatomic dimensions with resultant poorer knee society scoring system in those with larger mediolateral miswww.ghanamedj.org Volume 55 Number 4December 2021
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