Suboptimal knee prosthesis design for Vietnamese women: a computed tomography-based arthrometric study
, 21, 21, 1, 21, 321
Abstract
Background: Mismatches between knee dimensions and implant sizes can result in poor outcomes and dissatisfaction following total knee replacement. We aimed to evaluate knee morphology in Vietnamese women and assess the compatibility of available prostheses.
Materials and methods: Using the full-leg CT scan datasets, we reconstructed 3D models of knee joints with software. After simulating femoral and tibial bone cuts with the mechanical alignment, the anteroposterior (AP) and mediolateral (ML) widths of the resection surfaces were measured. Six available prostheses were analyzed for their compatibility and coverage percent of the resected bone.
Results: The study included 40 female patients with osteoarthritis (aged 51–79). AP and ML dimensions of distal femur were 63.07 ± 3.05 mm and 57.46 ± 3.06 mm; those of proximal tibia were 48.95 ± 3.01 mm and 67.14 ± 3.49 mm. Smaller knees exhibited higher femoral aspect ratio (ML/AP) compared to larger knees. Increasing the tibial AP resulted in a smaller ML length of the proximal tibia relative to the tibial component. With the AP and ML mismatch set at ± 1.5 and ± 3 mm, prosthesis system provided the best femoral component fit at only 67.5%. Tibial component coverage rates varied among implant systems, with the best fit prosthesis system covering 92.5% at a tolerance of ± 3 mm for both AP and ML dimensions.
Conclusions: The current prosthetic options show significant mismatches with the knee morphology of Vietnamese women, highlighting the need for better suited implant designs. Further research is necessary to develop suitable prosthetic solutions.
Keywords: knee dimensionstotal knee replacementVietnameseanthropometryprosthesis coverage
References
- Cheng FuBo, Ji XF, Lai Y, et al. Three dimensional morphometry of the knee to design the total knee arthroplasty for Chinese population. Knee. 2009; 16(5): 341–347.
- Chung BJ, Kang JY, Kang YG, et al. Clinical implications of femoral anthropometrical features for total knee arthroplasty in Koreans. J Arthroplasty. 2015; 30(7): 1220–1227.
- Eun Y, Yoo JE, Han K, et al. Female reproductive factors and risk of joint replacement arthroplasty of the knee and hip due to osteoarthritis in postmenopausal women: a nationwide cohort study of 1.13 million women. Osteoarthritis Cartilage. 2022; 30(1): 69–80.
- Grothues S, Hohlmann B, Zingde SM, et al. Potential for femoral size optimization for off-the-shelf implants: a CT derived implant database analysis. J Orthop Res. 2023; 41(6): 1198–1205.
- Gunaratne R, Pratt DN, Banda J, et al. Patient dissatisfaction following total knee arthroplasty: a systematic review of the literature. J Arthroplasty. 2017; 32(12): 3854–3860.
- Hitt K, Shurman J, Greene K, et al. Anthropometric measurements of the human knee. J Bone Joint Surg Am. 2003; 85(Suppl. 4): 115–122.
- Ke S, Ran T, Ma T, et al. A morphometric study of the distal femoral resected surface in osteoarthritis knees of the patients in southwest china and a comparison with femoral components in six total knee arthroplasty systems. Orthop Surg. 2023; 15(4): 953–960.
- Kim TK, Phillips M, Bhandari M, et al. What differences in morphologic features of the knee exist among patients of various races? A systematic review. Clin Orthop Relat Res. 2017; 475(1): 170–182.
- Mahfouz M, Abdel Fatah EE, Bowers LS, et al. Three-dimensional morphology of the knee reveals ethnic differences. Clin Orthop Relat Res. 2012; 470(1): 172–185.
- Mahoney OM, Kinsey T. Overhang of the femoral component in total knee arthroplasty: risk factors and clinical consequences. J Bone Joint Surg Am. 2010; 92(5): 1115–1121.
- Mohan H, Chhabria P, Bagaria V, et al. Anthropometry of nonarthritic Asian knees: is it time for a race-specific knee implant? Clin Orthop Surg. 2020; 12(2): 158–165.
- Nham FH, Patel I, Zalikha AK, et al. Epidemiology of primary and revision total knee arthroplasty: analysis of demographics, comorbidities and outcomes from the national inpatient sample. Arthroplasty. 2023; 5(1): 18.
- Phombut C, Rooppakhun S, Sindhupakorn B. Morphometric analysis and three-dimensional computed tomography reconstruction of thai distal femur. Applied Sciences. 2021; 11(3): 1052.
- Shakya H, Chen A, Zhou ZK. The increase in total knee replacement surgery in China: a 10-year real-world study. Open J Orthop. 2024; 14(06): 270–286.
- Xu Y, Feng B, Dong Y, et al. Morphology characters of resected femoral and tibial surface in chinese population: intraoperative anthropometric study in patients at a tertiary hospital. BMC Surg. 2022; 22(1): 144.
