Differences Between the Sexes in the Anatomy of the Anterior Condyle of the Knee (original) (raw)
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No Sex Differences Exist in Posterior Condylar Offsets of the Knee
Clinical Orthopaedics and Related Research®, 2014
Background Restoration of posterior condylar offset during TKA is believed to be important to improving knee kinematics, maximizing ROM, and minimizing flexion instability. However, controversy exists regarding whether there are important anatomic differences between sexes and whether a unisex knee prosthesis can restore the anatomy of knees in males and females. Questions/purposes The purposes of our study were to determine if sex differences exist in (1) absolute posterior condylar offset size, (2) relative posterior condylar offset size in relation to total condylar height, and (3) posterior condylar articular cartilage thickness. This work was performed at the A Publication of The Association of Bone and Joint Surgeons® greater total condylar height at the medial and lateral femoral condyles, however, there were no sex differences in the ratio of posterior condylar offset to condylar height at either condyle. Clinical Relevance These findings suggest that a unisex knee prosthesis design is adequate to recreate the normal posterior condylar offsets for men and women.
Gender analysis of the anterior femoral condyle geometry of the knee
The Knee, 2014
Background: No study has used 3-D anatomic knee models to investigate the gender differences in anterior femoral condyles. Therefore, this study aims to determine the morphologic differences between genders in anterior femoral condyles of the knees using 3-D anatomic knee models. Methods: Ninety-six male and sixty-five female 3D anatomic knee models were used to measure lateral and medial anterior condyle heights, anterior trochlear groove heights, and anterior condyle width, which were normalized by the anterior-posterior and medial-lateral dimensions of the knee, respectively. The shape of anterior condyle groove was also analyzed. Results: The mean lateral anterior condyle height, medial anterior condyle height and anterior condyle width of females were 6.6 ± 1.8 mm, 2.0 ± 2.3 mm, and 44.7 ± 4.2 mm, respectively. These data were significantly smaller (p b 0.05) than those of males (7.7 ± 1.8 mm, 2.9 ± 2.0 mm and 50.0 ± 3.4 mm). However, after normalizing by the femur size, the aspect ratios had no gender differences. Both the ranges of lateral and medial condyle of females were significantly smaller than those of males, and the geometry curve of anterior condyle was different between genders. Conclusion: Although the gender differences in anterior femoral condyle sizes no longer existed after normalization with the femur size, the shape and the peak position of anterior condyle groove still have gender differences. The data may have important implications on the current debate of gender-specific TKAs. Clinical relevance: This study provides a better understanding of gender differences in anterior femoral condyle geometry.
The female knee: anatomic variations and the female-specific total knee design
… and Related Research …, 2008
The concept and need for a gender-specific or female-specific total knee prosthesis have generated interest and discussion in the orthopaedic community and the general public. This concept relies on the assumption of a need for such a design and the opinion that there are major anatomic differences between male and female knees. Most of the information regarding this subject has been disseminated through print and Internet advertisements, and through direct-to-patient television and magazine promotions. These sources and a recent article in a peer-reviewed journal, which support the need for a female-specific implant design, have proposed three gender-based anatomic differences: (1) an increased Q angle, (2) less prominence of the anterior medial and anterior lateral femoral condyles, and (3) reduced medial-lateral to anterior-posterior femoral condylar aspect ratio. We examined the peer-reviewed literature to determine whether women have had worse results than men after traditional TKAs. We found women have equal or better results than men. In addition, we reviewed the evidence presented to support these three anatomic differences. We conclude the first two proposed differences do not exist, and the third is so small that it likely has no clinical effect.Level of Evidence: Level IV, systematic review. See the Guidelines for Authors for a complete description of levels of evidence.
Journal of Orthopaedic Surgery and Research, 2023
Background The aim of this magnetic resonance imaging (MRI) study was to investigate controversial sexual dimorphism of the posterior condylar offset of the femur (the offset) and the posterior slope of the tibia (the slope) in non-arthritic knees of Egyptian adults. Methods On 100 male and 100 female MRIs of non-arthritic knees, linear measurements of the distal part of the femur (the offset) and the angular measurements of the proximal part of the tibia (the slope) were performed and compared regarding sex and ethnicity. The intraclass correlation coefficient (ICC) was used to test the interrater agreement. Results Both offsets and the lateral offset ratio were larger in males (p < 0.001), the medial offset ratio, and the medial slope in females (p from < 0.001 to 0.007), whereas the lateral slope was sex-free (p = 0.41). Irrespective of sex, however, the medial offset with its ratio, and the medial slope were larger than their counterparts (p < 0.001). Our means of the offsets, their ratios, and the slopes mostly differed from those of other ethnicities (p from ≤ 0.001 to 0.004). ICCs > 0.8 proved MRI's precision was high. Conclusion There was a sexual dimorphism of both the offset and the medial slope in non-arthritic knees of Egyptian adults. We believe future designs of knee implants should consider these differences in order to improve postoperative range of motion and patients' satisfaction after total knee arthroplasty.
Gender differences in knee kinematics and its possible consequences
Croatian Medical Journal, 2005
Aim: To analyze anatomic and kinematic characteristics of male and female knees in the sagittal plane. Methods: Ten healthy male and 10 healthy female participants performed extension of their right lower leg in non-weight bearing and weight bearing conditions. The centers of knee joint motion were obtained by videographic motion analysis, and radii of condylar curves were calculated from digitalized X-ray scan. The Knee Roll software was made for this purpose. Results: The extension of the knee in non-weight loaded and weight loaded conditions is a combination of rolling and sliding joint surface motion with 6:5 ratio, in both genders. During the last 20 degrees of the extension of weight loaded male knee, rolling/sliding ratio changed to 8:1 (P<0.05). Average radii of condylar curves were between 4.5 and 1.7 cm medially, and between 3.2 and 1.8 cm laterally, for 0 degrees and 90 degrees flexion contact point, respectively. Gender differences in the radii of condylar curves, after the adjusting to body height were insignificant. Conclusion: A higher proportion of joint surface sliding with consecutive anterior tibial displacement in women indicates more strain during knee extension, potentially making the female anterior cruciate ligament tend and susceptible to injury. The gender differences in the knee kinematics are probably the consequence of different soft tissue structure or its activity, because no difference in the sagittal shape of femoral condyles was noted.
Medical Journal of Islamic World Academy of Sciences, 2019
Knee osteoarthritis is an arthropathy with a chronic and progressive course that negatively affects the daily activities of individuals, decreases their quality of life, and may result in the loss of articular cartilage at older ages (1-3). Total knee arthroplasty (TKA) is a good treatment option for patients with osteoarthritis suffering from secondary knee pain, who do not respond to conservative treatment. TKA is a reliable procedure that improves patients' functional status and relieves pain (3). Accurate bone-cutting, soft tissue balance, and adequate covering of the resected surface with the implant are important factors affecting successful outcomes in THA (4,5). Anatomical differences between sexes have been discussed in recent studies on TKA surgery (6). It is recommended that new prosthetic designs should be developed to ensure compliance with these anatomical differences (7). The anthropometric data are very important for the stability and long life of the implants to be used in TKA. TKA is expected to yield better results based on fully measured morphological data of the knee, morphological differences between sexes, and morphological compatibility between the tibia and the femur (8). This study aimed to perform morphometric measurements of distal femoral anatomy in healthy adults.
Gender differences in the anatomy of the distal femur
The Journal of bone and joint surgery. British volume, 2011
Recently, gender-specific designs of total knee replacement have been developed to accommodate anatomical differences between males and females. We examined a group of male and female distal femora matched for age and height, to determine if there was a difference in the aspect ratio (mediolateral distance versus anteroposterior distance) and the height of the anterior flange between the genders. The Hamann-Todd Collection provided 1207 skeletally mature cadaver femora. The femoral length, the anteroposterior height, height of the lateral and medial flanges and the mediolateral width were measured in all the specimens. The mechanical axis of the femur, the cut articular width and the aspect ratio were assessed. Statistical analysis of the effect of gender upon the aspect ratio and the lateral and medial flanges was undertaken, controlling for age, height and race. The mean aspect ratio of male femora was 1.21 (SD 0.07) and of female femora it was 1.16 (SD 0.06) (p < 0.001). There...
Variations of femoral condyle shape
Collegium antropologicum, 2005
The aim of this study is to mathematically approximate the shape of the femoral articulating line and compare radiuses of condylar curves within and between males and females. Ten male and ten female participants were included in the study. Radiuses of medial and lateral condylar curves were calculated from the side view knee X-ray by original mathematical equation. Average radiuses of condylar curves were between 4.5 and 1.7 cm medially, and between 3.2 and 1.8 cm laterally, for 0 degrees and 90 degrees flexion contact point respectively. Males had longer curve radiuses of both condyles (p < 0.05). Differences turned out to be statistically insignificant after adjusting to body height. Even small changes in the joint geometry during lifetime could make a joint susceptible to osteoarthritis or injuries. Approximation of the radiuses of femoral condyle curves is a useful method in anthropometric, radiological and virtual calculations of the knee geometry, and other ellipsoidal str...
Morphometric alteration of femoral condyles due to knee osteoarthritis
Collegium antropologicum, 2008
Aim of this study was to estimate how knee osteoarthritis (OA) affects the shape of femoral condyles by comparing the radiuses of condylar curves between healthy and OA knees. Seventeen female and five male patients with established diagnosis of knee OA were included in the study. Radiuses of medial and lateral condylar curves were calculated from the side view knee X-ray by original mathematical equation and compared to referent values of healthy knees, after adjusting to body height. The average radiuses of condylar curves were between 52.6 +/- 6.2 and 17.6 +/- 3.5 mm medially, and between 43.3 +/- 8.4 and 15.4 +/- 3.7 mm laterally for 0 degrees and 90 degrees femoral flexion contact points, respectively The OA knees had longer curve radiuses medially and laterally at 0 degrees, 10 degrees, and 20 degrees femoral flexion contact points in comparison to the healthy sample (P < 0.001; t-test). Our results suggest that the shape of the femoral condyles in OA knees is changed. It s...