Abstract
Introduction: Total knee arthroplasty (TKA) remains the treatment of choice for severe osteoarthritis of the knee and nearly 60% of patients undergoing TKA are women. Females present three notable anatomic differences. Thus, gender-specific (GS) components were introduced to accommodate the females’ anatomic differences. No systematic review has been published since 2014. The aim of this study was to perform a recent systematic review of the literature to determine whether there is any clinical benefit of gender-specific implants compared to conventional unisex implants in total knee arthroplasty (TKA). Methods: This study included prospective randomized controlled trials (PRCTs) comparing clinical and radiological outcomes, and complications in TKA with gender-specific implants and conventional implants. All studies had a minimum follow-up of two years. Results: Three PRCTs published between 2010 and 2012 were included. These studies showed a low risk of bias and were of very high quality. We did not find superior clinical outcomes for gender-specific prostheses compared to conventional prostheses. However, gender-specific TKA reduced the number of patients with femoral component overhang compared to conventional TKA. Conclusion: In our systematic review, despite a lower overhang rate, gender-specific implants in female TKA showed no clinical benefit over standard unisex implants. Good clinical results with significant improvement were observed with both designs. There is a notable absence of new studies on this subject in recent years, and further research needs to be performed using various gender-specific implant designs to further define the role of gender-specific implants. Level of evidence: Systematic review, Level IV
Highlights
Total knee arthroplasty (TKA) remains the treatment of choice for severe osteoarthritis of the knee [1] and nearly 60% of patients undergoing TKA are women [2,3,4]
The principal findings of this systematic review were as follows: the clinical results of GS TKA were similar to those of conventional TKA and a significantly reduced overhang rate was found for GS prostheses compared to conventional implants
GS knee prostheses were introduced based on the assumption that TKA outcomes might be inferior in women compared to men when using standard prostheses, one study reported that women achieved similar or even better results in terms of pain, satisfaction, range of motion, satisfaction, and implant survival when standard implants were used [32]
Summary
Total knee arthroplasty (TKA) remains the treatment of choice for severe osteoarthritis of the knee [1] and nearly 60% of patients undergoing TKA are women [2,3,4]. Outcomes of TKA are influenced by several factors. Women have a less prominent anterior condyle [13, 14], an increased quadriceps angle (Q angle) [15, 16], and a reduced mediolateral (ML)/anteroposterior (AP) aspect ratio [9, 17]. It has been emphasized that standard knee prostheses may not exactly match the native anatomy in female and male knees [18, 19]. This potential femoral component overhang may influence postoperative knee pain or reduce range of motion [10, 20, 21]
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