Abstract
Purpose
The aim of this study was to evaluate the anthropometric differences between knees of Indonesian Asians and Dutch Caucasians and the fit of nine different knee implant systems.
Methods
A total of 268 anteroposterior (AP) and lateral knee preoperative radiographs from 134 consecutive patients scheduled for total knee arthroplasty at two different centres in Jakarta and Leiden were included. Both patient groups were matched according to age and sex and included 67 Asians and 67 Caucasians. We assessed the radiographic differences between the Asian and Caucasian anthropometric data. The dimensions of the nine knee implant designs (Vanguard, Genesis II, Persona Standard, Persona Narrow, GK Sphere, Gemini, Attune Standard, Attune Narrow, and Sigma PFC) were compared with the patients’ anthropometric (distal femur and proximal tibia) measurements.
Results
The Dutch Caucasian patients had larger mediolateral (ML) and AP femoral and tibial dimensions than the Indonesian Asians. The aspect ratios of the distal femur and tibia were larger in Asians than in Caucasians. The AP and ML dimensions were mismatched between the tibial components of the nine knee systems and the Asian anthropometric data. Both groups had larger ML distal femoral dimensions than the knee systems.
Conclusion
Absolute and relative differences in knee dimensions exist not only between Asian and Caucasian knees but also within both groups. Not all TKA systems had a good fit with the Asian and Caucasian knee phenotypes. An increase in the range of available knee component sizes would be beneficial, although TKA remains an adequate compromise.
Level of evidence
III.
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References
Bellemans J, Colyn W, Vandenneucker H, Victor J (2012) The Chitranjan Ranawat award: is neutral mechanical alignment normal for all patients? The concept of constitutional varus. Clin Orthop Relat Res 470:45–53
Bloebaum RD, Bachus KN, Mitchell W, Hoffman G, Hofmann AA (1994) Analysis of the bone surface area in resected tibia. Implications in tibial component subsidence and fixation. Clin Orthop Relat Res 302:2–10
Bonnin MP, de Kok A, Verstraete M, Van Hoof T, Van der Straten C, Saffarini M, Victor J (2017) Popliteus impingement after TKA may occur with well-sized prostheses. Knee Surg Sports Traumatol Arthrosc 25:1720–1730
Bonnin MP, Saffarini M, Bossard N, Dantony E, Victor J (2016) Morphometric analysis of the distal femur in total knee arthroplasty and native knees. Bone Joint J 98B:49–57
Bonnin MP, Saffarini M, Nover L, Van der Maas J, Haeberle C, Hannink G, Victor J (2017) External rotation of the femoral component increases asymmetry of the posterior condyles. Bone Joint J 99B:894–903
Bonnin MP, Saffarini M, Shepherd D, Bossard N, Dantony E (2016) Oversizing the tibial component in TKAs: incidence, consequences and risk factors. Knee Surg Sports Traumatol Arthrosc 24:2532–2540
Bonnin MP, Schmidt A, Basiglini L, Bossard N, Dantony E (2013) Mediolateral oversizing influences pain, function, and flexion after TKA. Knee Surg Sports Traumatol Arthrosc 21:2314–2324
Budhiparama NC, Gaudiani MA, White PB, Satalich J, Nelissen RG, Ranawat AS, Ranawat CS (2019) A comparison of clinical and patient-reported outcome measures of TKR: comparison of Asian to North American patients. J Orthop Surg 27:230949901984455
Dutch Arthroplasty Register (LROI) (2018) Online LROI annual report 2018. https://www.lroi-report.nl. Accessed 09 Jun 2019
Ettinger M, Claassen L, Paes P, Calliess T (2016) 2D versus 3D templating in total knee arthroplasty. Knee 23:149–151
Gaillard R, Bankhead C, Budhiparama N, Batailler C, Servien E, Lustig S (2019) Influence of patella height on total knee arthroplasty: outcomes and survival. J Arthroplast 34:469–477
Gaizo D, Soileau E, Lachiewicz P (2009) Value of preoperative templating for primary total knee arthroplasty. J Knee Surg 22:284–293
Havet E, Gabrion A, Leiber-Wackenheim F, Vernois J, Olory B, Mertl P (2007) Radiological study of the knee joint line position measured from the fibular head and proximal tibial landmarks. Surg Radiol Anat 29:285–289
Hirschmann MT, Moser LB, Amsler F, Behrend H, Leclerq V, Hess S (2019) Functional knee phenotypes: a novel classification for phenotyping the coronal lower limb alignment based on the native alignment in young non-osteoarthritic patients. Knee Surg Sports Traumatol Arthrosc 27:1394–1402
Hitt K, Shurman JR, Greene K, McCarthy J, Moskal J, Hoeman T, Mont MA (2003) Anthropometric measurements of the human knee: correlation to the sizing of current knee arthroplasty systems. J Bone Joint Surg Am 85A:115–122
Hovinga KR, Lerner AL (2009) Anatomic variations between Japanese and Caucasian populations in the healthy young adult knee joint. J Orthop Res 27:1191–1196
Kawahara S, Matsuda S, Fukagawa S, Mitsuyasu H, Nakahara H, Higaki H, Shimoto T, Iwamoto Y (2012) Upsizing the femoral component increases patellofemoral contact force in total knee replacement. J Bone Joint Surg Br 94B:56–61
Kim D-I, Kwak D-S, Han S-H (2013) Sex determination using discriminant analysis of the medial and lateral condyles of the femur in Koreans. Forensic Sci Int 233:121–125
Kim H-A, Kim S, Seo YI, Choi HJ, Seong S-C, Song YW, Hunter D, Zhang Y (2008) The epidemiology of total knee replacement in South Korea: national registry data. Rheumatology 47:88–91
Kim TK, Phillips M, Bhandari M, Watson J, Malhotra R (2017) What differences in morphologic features of the knee exist among patients of various races? A systematic review. Clin Orthop Relat Res 475:170–182
Kwak D-S, Han S, Han CW, Han S-H (2010) Resected femoral anthropometry for design of the femoral component of the total knee prosthesis in a Korean population. Anat Cell Biol 43:252
Loures FB, de Araújo Góes RF, da Palma IM, Labronici PJ, Granjeiro JM, Olej B (2016) Anthropometric study of the knee and its correlation with the size of three implants available for arthroplasty. Rev Bras Ortop 51:282–289
Lum ZC, Shieh AK, Dorr LD (2018) Why total knees fail-a modern perspective review. World J Orthop 9:60–64
Mahfouz M, Abdel Fatah EE, Bowers LS, Scuderi G (2012) Three-dimensional morphology of the knee reveals ethnic differences. Clin Orthop Relat Res 470:172–185
Mahoney OM, Kinsey T (2010) Overhang of the femoral component in total knee arthroplasty: risk factors and clinical consequences. J Bone Joint Surg Am 92:1115–1121
Marmor S, Renault E, Valluy J, Saffarini M (2018) Over-voluming predicted by pre-operative planning in 24% of total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 27(5):1544–1551
McCrory P (2004) Campbell’s operative orthopaedics, 10th ed (4 vols). Br J Sports Med 38:367
Mensch JS, Amstutz HC (1975) Knee morphology as a guide to knee replacement. Clin Orthop Relat Res 112:231–241
Merchant AC, Arendt EA, Dye SF, Fredericson M, Grelsamer RP, Leadbetter WB, Post WR, Teitge RA (2008) The female knee: anatomic variations and the female-specific total knee design. Clin Orthop Relat Res 466:3059–3065
Mihalko W, Fishkin Z, Krakow K (2006) Patellofemoral overstuff and its relationship to flexion after total knee arthroplasty. Clin Orthop Relat Res 449:283–287
Ritter MA, Faris PM, Keating EM, Meding JB (1994) Postoperative alignment of total knee replacement. Its effect on survival. Clin Orthop Relat Res 299:153–156
Rojanasthien S, Okamoto R, Ozawa N, Koshino T (1989) Tibial plateau-fibular head distance of normal Japanese knees measured in lateral view of roentgenogram. Nihon Seikeigeka Gakkai Zasshi 63:1353–1357
Tamari K, Tinley P, Briffa K, Aoyagi K (2005) Ethnic-, gender-, and age-related differences in femorotibial angle, femoral antetorsion, and tibiofibular torsion: cross-sectional study among healthy Japanese and Australian Caucasians. Clin Anat 19:59–67
Thienpont E, Becker R (2014) Anthropometric measurements of the knee: time to make it fit. Knee Surg Sports Traumatol Arthrosc 22:2889–2890
Trickett RW, Hodgson P, Forster MC, Robertson A (2009) The reliability and accuracy of digital templating in total knee replacement. J Bone Joint Surg Br 91B:903–906
Urabe K, Miura H, Kuwano T, Matsuda S, Nagamine R, Sakai S, Masuda K, Iwamoto Y (2003) Comparison between the shape of resected femoral sections and femoral prostheses used in total knee arthroplasty in Japanese patients: simulation using three-dimensional computed tomography. J Knee Surg 16:27–33
Vaidya SV, Ranawat CS, Aroojis A, Laud NS (2000) Anthropometric measurements to design total knee prostheses for the Indian population. J Arthroplast 15:79–85
van Hamersveld KT, Marang-van de Mheen PJ, Nelissen RGHH (2019) The effect of coronal alignment on tibial component migration following total knee arthroplasty. J Bone Joint Surg 101:1203–1212
Westrich GH, Agulnick MA, Laskin RS, Haas SB, Sculco TP (1997) Current analysis of tibial coverage in total knee arthroplasty. Knee 4:87–91
Yang B, Song C, Yu J, Yang Y, Gong X, Chen L, Wang Y, Wang J (2014) Intraoperative anthropometric measurements of tibial morphology: comparisons with the dimensions of current tibial implants. Knee Surg Sports Traumatol Arthrosc 22:2924–2930
Yue B, Varadarajan KM, Ai S, Tang T, Rubash HE, Li G (2011) Differences of knee anthropometry between Chinese and white men and women. J Arthroplast 26:124–130
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This study was performed with the approval of the institutional review board of Medistra Hospital (ID 0867a.1.B.5.09).
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Budhiparama, N.C., Lumban-Gaol, I., Ifran, N.N. et al. Mismatched knee implants in Indonesian and Dutch patients: a need for increasing the size. Knee Surg Sports Traumatol Arthrosc 29, 358–369 (2021). https://doi.org/10.1007/s00167-020-05914-9
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DOI: https://doi.org/10.1007/s00167-020-05914-9