Ranjan Mithilesh, Rangaswamy Namith, Garika Siva Srivastava, Yadav Chandrashekhar
Department of Orthopedics, All India Institute of Medical Sciences, New Delhi, New Delhi, IND.
Department of Orthopedics, Primus Super Speciality Hospital, New Delhi, New Delhi, IND.
Cureus. 2022 Oct 29;14(10):e30824. doi: 10.7759/cureus.30824. eCollection 2022 Oct.
Total knee arthroplasty (TKA) has been proven to be a highly efficacious procedure for patients with end-stage osteoarthritis who have persistent symptoms not managed by conservative treatment. A large percentage of standard commercially available total knee arthroplasty (TKA) implants are imported and designed based on morphometric data of Western populations, which are known to have a larger build compared to their Asian counterparts. Hence, these prostheses may sometimes not be the best fit for Indian patients. We conducted this study to examine the anthropometry of osteoarthritic knees of Indian patients, analyze anatomical differences between males and females, and compare these measurements with commercially available five TKA implants.
Morphometric data were collected from 150 Indian patients with osteoarthritis of the knee using computed tomography (CT) scans. The mediolateral (ML) and anteroposterior (AP) dimensions of the distal femur and proximal tibia were measured, and aspect ratios (ML/AP) were calculated. These measurements were correlated with current commercially available implant sizes.
We examined CT scans of 100 female and 50 male patients' knees with a combined average age of 58.2 ± 7.5 years. The mean mediolateral and anteroposterior dimensions of the distal femur for Indian knees were 74.5 ± 5.8 mm and 58.0 ± 4.2 mm, respectively, whereas for the proximal tibia, 69.1 ± 5.5 mm and 43.8 ± 3.6, respectively. The mean aspect ratio for the femur was 129.0 ± 6.0 and for the tibia was 158.1 ± 9.1. Male dimensions were found to be greater than female dimensions in all measured aspects of the distal femur and proximal tibia for the Indian population. However, the aspect ratio of the tibia was not found to vary with gender. When compared with the dimensions of other ethnic groups, the size of Indian knees was found to be smaller than Caucasians.
There is a mismatch between the anatomy of Indian knees and currently available TKA implants, and these implants may have drawbacks when implanted in Indian patients. The obtained anthropometric data may provide useful directions for designing TKA implants of more suitable sizes and aspect ratios for Indian patients.
全膝关节置换术（TKA）已被证明对于终末期骨关节炎且经保守治疗症状仍持续的患者是一种高效的手术。很大比例的市售标准全膝关节置换术（TKA）植入物是进口的，并且是基于西方人群的形态测量数据设计的，众所周知，西方人群的体型比亚洲人群更大。因此，这些假体有时可能并非最适合印度患者。我们开展这项研究以检查印度患者骨关节炎膝关节的人体测量学，分析男性和女性之间的解剖差异，并将这些测量结果与市售的五种TKA植入物进行比较。
使用计算机断层扫描（CT）从150名印度膝关节骨关节炎患者收集形态测量数据。测量股骨远端和胫骨近端的内外侧（ML）和前后径（AP）尺寸，并计算纵横比（ML/AP）。这些测量结果与当前市售植入物尺寸相关联。
我们检查了100名女性和50名男性患者膝关节的CT扫描，平均年龄为58.2±7.5岁。印度人膝关节股骨远端的平均内外侧和前后径分别为74.5±5.8毫米和58.0±4.2毫米，而胫骨近端分别为69.1±5.5毫米和43.8±3.6毫米。股骨的平均纵横比为129.0±6.0，胫骨的平均纵横比为158.1±9.1。在印度人群中，在股骨远端和胫骨近端的所有测量方面，男性尺寸均大于女性尺寸。然而，未发现胫骨的纵横比随性别而变化。与其他种族群体的尺寸相比，发现印度人膝关节的尺寸小于白种人。
印度人膝关节的解剖结构与目前可用的TKA植入物不匹配，并且这些植入物植入印度患者时可能存在缺点。所获得的人体测量数据可能为设计更适合印度患者尺寸和纵横比的TKA植入物提供有用的指导。
