The female knee: anatomic variations and the female-specific total knee design.
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.


METHODS
Level IV, systematic review. See the Guidelines for Authors for a complete description of levels of evidence.
Merchant
Alan C
AC
Department of Orthopaedic Surgery, Stanford University School of Medicine, 124 Marvin Avenue, Los Altos, CA 94022, USA. kneemd@sbcglobal.net
Arendt
Elizabeth A
EA
Dye
Scott F
SF
Fredericson
Michael
M
Grelsamer
Ronald P
RP
Leadbetter
Wayne B
WB
Post
William R
WR
Teitge
Robert A
RA
D019645:Arthroplasty, Replacement, Knee; D005260:Female; D006801:Humans; D007717:Knee / Q000033:anatomy & histology*; D007720:Knee Prosthesis; D011474:Prosthesis Design; D017755:Prosthesis Fitting; D012727:Sex Characteristics; D016896:Treatment Outcome