Automatic and manual methodology for three-dimensional measurements of distal femoral gender differences and femoral component placement.

Our study aimed to introduce an automatic three-dimensional method for measuring the distal femur and identifying potential gender differences and the effects on femoral component placement in total knee arthroplasty. Three hundred forty-two femora were scanned with computed tomography. Automatic and manual bone resection and component placement were compared using a virtual resection tool. For standard component use, 77.3% of the femora were male and 23.1% were female. For gender-specific component use, 91% were female and 7.3% were male. Surgeon errors in both component translation and rotation existed but were minimal. From these results, gender alone did not dictate component use in primary total knee arthroplasty. The restoration of femoral condylar profile in 3 dimensions can be obtained by accurately measuring patient distal femoral anatomy and the appropriate femoral component design selection. Additional bone cuts, soft-tissue maneuvers, and adverse outcomes in fitting the patient to the femoral component may be avoided.