Sports Medicine Department, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Beijing, China.
Department of Orthopaedics, Shaanxi Provincial People's Hospital, The Third Affiliated hospital of Xi'an jiaotong University, Xi'an, China.
PLoS One. 2024 Feb 26;19(2):e0297634. doi: 10.1371/journal.pone.0297634. eCollection 2024.
The anterior flange height of the current femoral component increases with an increasing distal femoral anteroposterior dimension. During total knee arthroplasty (TKA), we have observed that a large femur may have a thinner anterior condyle, whereas a small femur may have a thicker anterior condyle. The first purpose of this study was to examine whether the femoral anterior condyle height decreases as the distal femoral anteroposterior size increases and whether gender differences exist in anterior condyle height.
A total of 1218 knees undergoing TKA intraoperative and computed tomography scans from 303 healthy knees were used to measure the anterior lateral condylar height (ALCH), anterior medial condylar height (AMCH), and the lateral anteroposterior (LAP) and medial anteroposterior (MAP) dimensions of distal femurs. The LAP and MAP measurements were used for adjustments to determine whether gender differences exist in anterior condyle heights. Linear regression analysis was performed to determine correlations between ALCH and LAP or between AMCH and MAP.
There were significant differences between males and females in ALCH in both the CT and TKA groups and AMCH in the CT group (all P<0.01). After adjusting for LAP and MAP, there were significant gender differences in the lateral and medial condylar heights in both groups (P<0.01). There were significant negative correlations between ALCH and LAP values and between AMCH and MAP values in both CT and TKA measurements, with the LAP and MAP values increasing as ALCH and AMCH decreased.
The results demonstrate that femoral anterior condylar height decreased with increasing anteroposterior dimension in both the medial and lateral condyle. In addition, this study also showed that anterior condylar heights are highly variable, with gender differences. The data may provide an important reference for designing femoral anterior flange thickness to precisely match the natural anterior condylar anatomy.
当前股骨假体的前翼高度随股骨远端前后径的增加而增加。在全膝关节置换术（TKA）中，我们观察到较大的股骨可能前髁较薄，而较小的股骨可能前髁较厚。本研究的首要目的是检验股骨前髁高度是否随股骨远端前后径的增加而降低，以及前髁高度是否存在性别差异。
共纳入 303 例健康膝关节行 TKA 术中及 CT 扫描的 1218 例膝关节，测量其股骨前外侧髁高度（ALCH）、前内侧髁高度（AMCH）及股骨远端的外侧前后径（LAP）和内侧前后径（MAP）。采用 LAP 和 MAP 测量值进行调整，以确定前髁高度是否存在性别差异。行线性回归分析以确定 ALCH 与 LAP 或 AMCH 与 MAP 之间的相关性。
CT 组和 TKA 组中男性的 ALCH 以及 CT 组中男性的 AMCH 均显著大于女性（均 P<0.01）。经 LAP 和 MAP 调整后，两组的外侧和内侧髁高度均存在显著的性别差异（P<0.01）。在 CT 和 TKA 测量中，ALCH 与 LAP 值、AMCH 与 MAP 值之间均存在显著的负相关，即随着 LAP 和 MAP 值的增加，ALCH 和 AMCH 值减小。
结果表明，在股骨内外侧髁中，前髁高度随前后径的增加而降低。此外，本研究还表明，前髁高度差异较大，存在性别差异。这些数据可为设计股骨前翼厚度提供重要参考，以精确匹配自然前髁解剖结构。
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