Distal femur morphometry: a gender and bilateral comparative study using magnetic resonance imaging

Abstract

Among the anthropometric factors to be considered, anatomic differences in the distal femur and intercondylar notch have been implicated as a cause of the different rates of anterior cruciate ligament (ACL) rupture between men and women; therefore, in this study our aim was to evaluate a number of morphometric measurements in the distal part of the femur. Two hundred knee MRI examinations were analyzed: 56 male right, 44 male left, 42 female right and 58 female left. Measurements of the intercondylar height (ICH), intercondylar width (ICW), medial condylar width (MCW), lateral condylar width (LCW) and epicondylar width (EW) were obtained. The notch shape index (NSI) was also calculated. Statistical analysis for comparisons was done by Student's t-test. Correlations between the parameters studied were calculated by Pearson correlation coefficients. Significant bilateral differences were not found (p > 0.05). In all measurements, males showed significantly greater values than females (p < 0.001). No difference was seen in the NSI between males and females (p > 0.05). Conversely a significant association was obtained between age and all parameters. We conclude that the results of this study may be useful for anatomic evaluation of the distal femur region prior to orthopaedic operations.

The John Insall Award: Both Morphotype and Gender Influence the Shape of the Knee in Patients Undergoing TKA

“…Each mediolateral over anteroposterior femoral ratio that we studied was indeed smaller for female patients compared with male and therefore confirms what other authors have published before [7,14,17,20]. At first sight, this may seem paradoxical because our study has also demonstrated small knees are wider in mediolateral versus anteroposterior femoral ratios compared with larger-sized knees.…”

“…Data from the literature suggest that for any given anteroposterior femoral dimension, women tend to have more narrow mediolateral dimensions than men [7,14,17,20,21]. The use of standard implants could, therefore, in theory, lead to mediolateral overhang in women, causing irritation and pain of the soft tissue capsular envelope of the knee.…”

Are the Left and Right Proximal Femurs Symmetric?

“…The dimensions of the femur are affected by gender and ethnicity [8,16,20,26,31,40,43,44]. Other than a small correlation between increased height and increased AP femoral head symmetry, there was no association between asymmetry and age, weight, height, ethnicity, and gender.…”

“…Studies of ethnic variations of morphologic features of the femur showed differences in femoral head diameters, femoral offset, and shaft diameters between European and Asian populations [18,43]. Research on bilateral femoral asymmetry has focused on properties such as bone mineral density, mechanical strength, cortex thickness, torsion angles, limb lengths, or the distal femur [8,26,28,32,36,40]. The studies that have researched asymmetry between Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.…”

Morphometric Study of Lower End of Dry Femur in Gujarat Region and Its Clinical Implication

“…Mismatch between Morphometric data and selected prosthesis may cause severe complications like anterior cruciate ligament rupture, soft tissue imbalance, decreased movements of knee and implant loosening. [3,[5][6][7][8][9] So knee prosthesis made based on morphometric data of components of knee (femur and tibia) and according to gender will give better results in early mobility as well as less complications [2,4]. Recent studies are based on difference between gender and ethnic groups.…”