title: Gender differences in the morphology of the trochlea and the distal femur.
abstract: OBJECTIVE
  The objective of this study was to provide a morphologic description of the distal femur and to determine whether there are any gender differences in the shape that might have an important consequence for the design of a femoral component of a total knee prosthesis.
  
  
  METHODS
  Anthropometric data on the distal femur of 200 normal knees were obtained using two-dimensional MRI measurements. In all 18 parameters of the distal femur were measured including the anteroposterior (AP) dimension of femoral condyles, the mediolateral (ML) width of the distal femur at four levels, and the AP dimension and ML width of the trochlea. The aspect ratios between the AP and ML dimensions were calculated to determine whether there is a shape difference between genders.
  
  
  RESULTS
  The female distal femur is significantly smaller in all measured parameters. The mean AP/ML aspect ratio of the female distal femur is significantly larger (p<0.05) at all measured ML levels except that of the anterior edge of the anterior chamfer. The AP dimensions of both the medial and lateral trochlea were significantly greater in men (p<0.001), but AP/ML aspect ratio did not differ between genders.
  
  
  CONCLUSIONS
  We have found that although the female distal femur is relatively narrower (larger AP/ML aspect ratio) than the male in three of the four measured levels, there is no significant difference between genders at the level of the anterior edge of the anterior chamfer. It is at this level that it has been suggested that impingement between soft tissues and an overhanging prosthesis is most likely to be painful. Equally, there were no gender-related differences in the shape of the trochlea. These data therefore do not support the provision of narrow femoral components for TKA for women.
authors.affiliation: 1st Orthopaedic Clinic, 1st Faculty of Medicine, Charles University, V Uvalu 84, 150 06, Prague 5, Czech Republic, vpins@lf1.cuni.cz.
authors.forename: V
authors.initials: V
authors.lastname: Pinskerova
authors.forename: K
authors.initials: K
authors.lastname: Nemec
authors.forename: I
authors.initials: I
authors.lastname: Landor
mesh_terms: D000293:Adolescent; D000328:Adult; D000886:Anthropometry; D019645:Arthroplasty, Replacement, Knee / Q000379:methods; D005260:Female; D005269:Femur / Q000033:anatomy & histology* / Q000601:surgery; D006801:Humans; D007717:Knee / Q000601:surgery; D007719:Knee Joint / Q000601:surgery; D007720:Knee Prosthesis; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery; D010146:Pain / Q000601:surgery; D012727:Sex Characteristics; D055815:Young Adult
references.citation: Clin Orthop Relat Res. 2008 Dec;466(12):3059-65
references.pmid: 18820981
references.citation: J Bone Joint Surg Am. 1991 Mar;73(3):397-409
references.pmid: 2002078
references.citation: Clin Orthop Relat Res. 2008 Nov;466(11):2711-6
references.pmid: 18719972
references.citation: Knee. 2014 Jan;21(1):252-6
references.pmid: 23245733
references.citation: Knee Surg Sports Traumatol Arthrosc. 2012 Jul;20(7):1282-8
references.pmid: 22057353
references.citation: J Knee Surg. 2002 Fall;15(4):213-7
references.pmid: 12416902
references.citation: J Arthroplasty. 2011 Apr;26(3):346-53
references.pmid: 20206467
references.citation: Knee Surg Sports Traumatol Arthrosc. 2011 Jan;19(1):80-8
references.pmid: 20407755
references.citation: Clin Orthop Relat Res. 2008 Nov;466(11):2612-6
references.pmid: 18800216
references.citation: Knee. 2012 Aug;19(4):488-92
references.pmid: 21775148
references.citation: Clin Orthop Relat Res. 2008 Nov;466(11):2724-9
references.pmid: 18719975
references.citation: J Arthroplasty. 2000 Jan;15(1):79-85
references.pmid: 10654467
references.citation: Knee. 2012 Jan;19(1):28-31
references.pmid: 21277212
references.citation: J Bone Joint Surg Br. 2001 Apr;83(3):355-8
references.pmid: 11341419
references.citation: J Orthop Res. 2012 May;30(5):686-92
references.pmid: 22025249
references.citation: Orthopedics. 2006 Sep;29(9):768-9
references.pmid: 17004583
references.citation: J Bone Joint Surg Am. 2003;85-A Suppl 4:115-22
references.pmid: 14652402
references.citation: AJR Am J Roentgenol. 2006 Jun;186(6):1778-82
references.pmid: 16714673
references.citation: Clin Orthop Relat Res. 2011 Oct;469(10):2855-65
references.pmid: 21698485
references.citation: J Am Acad Orthop Surg. 2007;15 Suppl 1:S31-6
references.pmid: 17766787
references.citation: Knee. 2013 Jan;20(1):26-30
references.pmid: 22721912
references.citation: Knee Surg Relat Res. 2012 Sep;24(3):180-5
references.pmid: 22977796
references.citation: J Bone Joint Surg Br. 2007 Nov;89(11):1452-6
references.pmid: 17998180
references.citation: Knee. 2011 Jan;18(1):5-10
references.pmid: 20133135
references.citation: Knee. 2009 Oct;16(5):341-7
references.pmid: 19230678
references.citation: J Bone Joint Surg Am. 2004 Jul;86(7):1479-84
references.pmid: 15252096
references.citation: Clin Orthop Relat Res. 2011 Jul;469(7):1852-8
references.pmid: 21264555
references.citation: Knee Surg Sports Traumatol Arthrosc. 2014 Dec;22(12):2941-6
references.pmid: 24105348
references.citation: Clin Orthop Relat Res. 2007 Nov;464:27-31
references.pmid: 17891041
references.citation: Clin Orthop Relat Res. 1996 Oct;(331):35-46
references.pmid: 8895617
references.citation: J Arthroplasty. 2008 Apr;23(3):331-6
references.pmid: 18358368
references.citation: Clin Orthop Relat Res. 2012 Jan;470(1):172-85
references.pmid: 21948324
references.citation: Clin Orthop Relat Res. 2010 Jan;468(1):29-36
references.pmid: 19669385
references.citation: J Bone Joint Surg Am. 2010 May;92(5):1115-21
references.pmid: 20439656