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The John Insall award: both morphotype and gender influence the shape of the knee in patients undergoing TKA

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Abstract
There is an ongoing debate whether gender differences in the dimensions of the knee should influence the design of TKA components. We hypothesized that not only gender but also the patient's morphotype determined the shape of the distal femur and proximal tibia and that this factor should be taken into account when designing gender-specific TKA implants. We reviewed all 1000 European white patients undergoing TKA between April 2003 and June 2007 and stratified each into one of three groups based on their anatomic constitution: endomorph, ectomorph, or mesomorph. Of the 250 smallest knees, 98% were female, whereas 81% of the 250 largest knees were male. In the group with intermediate-sized knees, female knees were narrower than male knees. Patients with smaller knees (predominantly female) demonstrated large variability between narrow and wide mediolateral dimensions irrespective of gender. The same was true for larger knees (predominantly male). This variability within gender could partially be explained by morphotypic variation. Patients with short and wide morphotype (endomorph) had, irrespective of gender, wider knees, whereas patients with long and narrow morphotype (ectomorph) had narrower knees. The shape of the knee is therefore not only dependent on gender, but also on the morphotype of the patient.
Keywords
SIZE, MEN, WOMEN, DESIGN, DISTAL FEMUR, ANATOMIC VARIATIONS, BODY-COMPOSITION, FEMALE KNEE, ARTHROPLASTY, SOMATOTYPE

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Chicago
Bellemans, Johan, Karel Carpentier, Hilde Vandenneucker, Johan Vanlauwe, and Jan Victor. 2010. “The John Insall Award: Both Morphotype and Gender Influence the Shape of the Knee in Patients Undergoing TKA.” Clinical Orthopaedics and Related Research 468 (1): 29–36.
APA
Bellemans, J., Carpentier, K., Vandenneucker, H., Vanlauwe, J., & Victor, J. (2010). The John Insall award: both morphotype and gender influence the shape of the knee in patients undergoing TKA. CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 468(1), 29–36. Presented at the Open Scientific Meeting of the Knee Society.
Vancouver
1.
Bellemans J, Carpentier K, Vandenneucker H, Vanlauwe J, Victor J. The John Insall award: both morphotype and gender influence the shape of the knee in patients undergoing TKA. CLINICAL ORTHOPAEDICS AND RELATED RESEARCH. 2010;468(1):29–36.
MLA
Bellemans, Johan, Karel Carpentier, Hilde Vandenneucker, et al. “The John Insall Award: Both Morphotype and Gender Influence the Shape of the Knee in Patients Undergoing TKA.” CLINICAL ORTHOPAEDICS AND RELATED RESEARCH 468.1 (2010): 29–36. Print.
@article{1967417,
  abstract     = {There is an ongoing debate whether gender differences in the dimensions of the knee should influence the design of TKA components. We hypothesized that not only gender but also the patient's morphotype determined the shape of the distal femur and proximal tibia and that this factor should be taken into account when designing gender-specific TKA implants. We reviewed all 1000 European white patients undergoing TKA between April 2003 and June 2007 and stratified each into one of three groups based on their anatomic constitution: endomorph, ectomorph, or mesomorph. Of the 250 smallest knees, 98\% were female, whereas 81\% of the 250 largest knees were male. In the group with intermediate-sized knees, female knees were narrower than male knees. Patients with smaller knees (predominantly female) demonstrated large variability between narrow and wide mediolateral dimensions irrespective of gender. The same was true for larger knees (predominantly male). This variability within gender could partially be explained by morphotypic variation. Patients with short and wide morphotype (endomorph) had, irrespective of gender, wider knees, whereas patients with long and narrow morphotype (ectomorph) had narrower knees. The shape of the knee is therefore not only dependent on gender, but also on the morphotype of the patient.},
  author       = {Bellemans, Johan and Carpentier, Karel and Vandenneucker, Hilde and Vanlauwe, Johan and Victor, Jan},
  issn         = {0009-921X},
  journal      = {CLINICAL ORTHOPAEDICS AND RELATED RESEARCH},
  keyword      = {SIZE,MEN,WOMEN,DESIGN,DISTAL FEMUR,ANATOMIC VARIATIONS,BODY-COMPOSITION,FEMALE KNEE,ARTHROPLASTY,SOMATOTYPE},
  language     = {eng},
  location     = {Las Vegas, NV, USA},
  number       = {1},
  pages        = {29--36},
  title        = {The John Insall award: both morphotype and gender influence the shape of the knee in patients undergoing TKA},
  url          = {http://dx.doi.org/10.1007/s11999-009-1016-2},
  volume       = {468},
  year         = {2010},
}

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