A Morphometric Study of the Distal Femoral Resected Surface In Osteoarthritis Knees of the Patients in Southwest China and a Comparison with Femoral Components in Six Total Knee Arthroplasty Systems

Abstract

ObjectiveMismatch between the femoral component and the resected surface is related to the postoperative clinical outcome. This study aimed to measure the morphometric features of the distal femoral resected surfaces in patients with osteoarthritis in southwestern China and to compare the measured morphometric data with six commonly used total knee arthroplasty (TKA) femoral components in China. MethodThe computer tomography (CT) images of a total of 406 knees from 203 osteoarthritis patients who underwent TKA from January 2018 to December 2021 were imported into Mimics 21.0 software to reconstruct the three-dimensional (3D) model of the femur. Morphometric data of the distal femoral resected surfaces were measured after the completion of simulated bone resection in the software. The data included the medial-lateral (ML) dimension, anterior-posterior (AP) dimension, and the aspect ratio (AR) (AR = ML/AP), which were compared between genders with independent sample t-tests. In addition, we plotted the scatter diagram of those morphometric data in Origin software, and the linear fits of ML versus AP and AR versus AP were performed and compared for the six femoral components commonly used in enrolled patients in China. ResultsThe mean ML dimension, the mean AP dimension, and the mean AR value measured for Chinese knees were 66.62 +/- 4.57 mm, 58.10 +/- 3.74 mm, and 1.15 +/- 0.06 respectively. All dimensions were significantly larger in males than in females, including the calculated values for AR (P < 0.05). The fitted lines for males showed that the ML dimensions tended to be wider compared to femoral components of a given AP dimension. Females tended to have wider ML dimensions compared to small femoral components and, on the other hand, narrower ML dimensions compared to large femoral components. ConclusionThe femoral component of the current commonly used TKA prosthesis in China may not be perfectly matched to the distal femoral resected surface of patients in southwestern China. Male patients tended to underhang in all dimensions of the ML dimension. Female patients with shorter AP lengths are more likely to experience underhang, whereas those with longer AP lengths are more likely to develop overhangs. Therefore, we recommend multiple ML width options for a given AP length to more appropriately match the Chinese femoral anatomy.