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3D Morphological Study of the Indian Arthritic Knee: Comparison with Other Ethnic Groups and Conformity of Current TKA Implant*

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DOI: 10.4236/ojra.2013.34041    2,806 Downloads   4,704 Views   Citations

ABSTRACT

Background: Studies have shown that there are striking variations in knee morphology between Asian and Western population. However, most of the existing total knee arthroplasty (TKA) implants are designed to suit the anatomy of Western population. Our study investigated anthropometry of Indian arthritic knees and compared them to international ethnic groups. Methods: Computed tomography was used to create 3D knee models and obtain anthropometric data of distal femur and proximal tibia of Indian arthritic knees. Femoral measurements included mediolateral length, medial and lateral anteroposterior length, medial and lateral condylar width and aspect ratio. Tibial measurements included mediolateral length, medial, lateral and central anteroposterior length and aspect ratio. A preoperative virtual implantation using Western TKAimplants was carried out to visualize anatomical conformity. Results: Statistical analysis results showed that Indian males had significantly larger femoral and tibial mediolateral and anteroposterior width than Indian females; however, femoral and tibial aspect ratio was similar for both. In case of females, significant difference was observed between medial and lateral condylar widths. When compared to knee anthropometry of other ethnic groups, femoral and tibial aspect ratio of Indian knees was found to be similar to the Asian population and different from the Western population. The virtual implantation showed overhang of the femoral component in both lateral and medial regions. Conclusion: Morphological mismatch between Western and Indian knees established the fact that Western implants have drawbacks when implanted in Indian patients. The study also provided a basis for designing gender-specific TKA implants for the Indian population.

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D. Shah, R. Ghyar, B. Ravi and V. Shetty, "3D Morphological Study of the Indian Arthritic Knee: Comparison with Other Ethnic Groups and Conformity of Current TKA Implant*," Open Journal of Rheumatology and Autoimmune Diseases, Vol. 3 No. 4, 2013, pp. 263-269. doi: 10.4236/ojra.2013.34041.

References

[1] S. J. Incavo, P. J. Ronchetti, J. G. Howe and J. P. Tranowski, “Tibial Plateau Coverage in Total Knee Arthroplasty,” Clinical Orthopaedics, Vol. 299, 1994, pp. 81-85.
[2] C. K. Cheng, C. Y. Lung, Y. M. Lee and C. H. Huang, “A New Approach of Designing the Tibial Base Plate of Total Knee Prostheses,” Clinical Biomechanics, Vol. 14, No. 2, 1999, pp. 112-117. http://dx.doi.org/10.1016/S0268-0033(98)00054-0
[3] W. P. Ho, C. K. Cheng and J. J. Liau, “Morphometrical Measurements of Resected Surface of Femurs in Chinese Knees: Correlation to the Sizing of Current Femoral Implants,” Knee, Vol. 13, No. 1, 2006, pp. 12-14. http://dx.doi.org/10.1016/j.knee.2005.05.002
[4] K. Urabe, H. Miura, T. Kuwano, et al., “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,” The Journal of Knee Surgery, Vol. 16, No. 1, 2003, pp. 27-33.
[5] S. V. Vaidya, C. S. Ranawat, A. Aroojis and N. S. Laud, “Anthropometric Measurements to Design Total Knee Pro-stheses for the Indian Population,” The Journal of Arthroplasty, Vol. 15, No. 1, 2000, pp. 79-85. http://dx.doi.org/10.1016/S0883-5403(00)91285-3
[6] G. H. Westrich, S. B. Haas and J. N. Insall, “Resection Specimen Analysis of Proximal Tibial Anatomy Based on 100 Total Knee Arthroplasty Specimens,” The Journal of Arthroplasty, Vol. 10, No. 1, 1995, pp. 47-51.
[7] K. Uehara, Y. Kadoya, A. Kobayashi, H. Ohashi and Y. Yamano, “Anthropometry of the Proximal Tibia to Design a Total Knee Prosthesis for the Japanese Population,” The Journal of Arthroplasty, Vol. 17, No. 8, 2002, pp. 1028-1032. http://dx.doi.org/10.1054/arth.2002.35790
[8] H. A. Kim, S. Kim, Y. I. Seo, et al., “The Epidemiology of Total Knee Replacement in South Korea: National Registry Data,” Rheumatology Oxford, Vol. 47, No. 1, 2008, p. 88. http://dx.doi.org/10.1093/rheumatology/kem308
[9] D. S. Kwak, S. Sibin, G. Patinharayil, et al., “Morphometry of the Proximal Tibia to Design the Tibial Component of Total Knee Arthroplasty for the Korean Population,” Knee, Vol. 14, No. 4, 2007, pp. 295-300. http://dx.doi.org/10.1016/j.knee.2007.05.004
[10] B. Yue, M. V. Kartik, A. Songtao, T. Tingting, E. R. Harry and L. Guoan, “Differences of Knee Anthropometry between Chinese and White Men and Women,” The Journal of Arthroplasty, Vol. 26, No. 1, 2011, pp. 124-130. http://dx.doi.org/10.1016/j.arth.2009.11.020
[11] M. P. Bonnin, S. Mohammed, P. E. Mercier, J. R. Laurent and C. Yannick, “Is the Anterior Tibial Tuberosity a Reliable Rotational Landmark for the Tibial Component in Total Knee Arthroplasy?” The Journal of Arthroplasty, Vol. 26, No. 2, 2011, pp. 260-267. http://dx.doi.org/10.1016/j.arth.2010.03.015
[12] R. A. Berger, H. E. Rubash, M. J. Seel, W. H. Thompson and L. S. Crossett, “Determining the Rotational Alignment of the Femoral Component in Total Knee Arthroplasty Using the Epicondylar Axis,” Clinical Orthopaedics and Related Research, Vol. 286, 1993, pp. 40-47.
[13] F. B. Cheng, X. F. Ji, Y. Lai, et al., “Three Dimensional Morphometry of the Knee to Design the Total Knee Arthroplasty for Chinese Population,” Knee, Vol. 16, No. 5, 2009, pp. 341-347. http://dx.doi.org/10.1016/j.knee.2008.12.019
[14] J. Mensch and H. Amstutz, “Knee Morphology as a Guide to Knee Replacement,” Clinical Orthopaedics and Related Research, Vol. 112, 1975, pp. 231-241.
[15] P. L. Poilvache, J. N. Insall, G. R. Scuderi, et al., “Rotational Landmarks and Sizing of the Distal Femur in Total Knee Arthroplasty,” Clinical Orthopaedics and Related Research, Vol. 331, 1996, pp. 35-46.
[16] I. S. Lee, J. A. Choi, T. K. Kim, I. Han, J. W. Lee and H. S. Kang, “Reliability Analysis of 16-MDCT in Preoperative Evaluation of Total Knee Arthroplasty and Comparison with Intraoperative Measurements,” American Journal of Roentgenology, Vol. 186, No. 6, 2006, pp. 1778-1782. http://dx.doi.org/10.2214/AJR.05.1191

  
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