Morphometry of femoral rotation for total knee prosthesis according to gender in a Korean population using three-dimensional magnetic resonance imaging

We aimed to evaluate differences in femoral arthometric data for 700 osteoarthritic knees (587 females and 113 males) with respect to gender in a Korean population.

We identified and measured the mediolateral (ML) and anteroposterior (AP) lengths, femoral aspect ratio (ML/AP), surgical epicondylar axis (SEA), and Whiteside’s line (WL). In addition, the anterior, posterior, and distal bone resections of the implanted femurs were evaluated using SEA and WL as references using a three-dimensional analysis method.

ML and AP lengths significantly differed according to gender. ML dimension and aspect ratio were greater in males than in females for a given AP dimension in the femur. No statistically significant differences in femoral rotation with SEA as a reference were observed between male and female knees; however, a significant difference was shown using WL as a reference and both affected the amount of bone resection irrespective of gender.

This study provides important guidelines for gender-specific femoral prosthesis design with different ML and AP aspect ratios and femoral rotation based on SEA and WL for Korean populations.