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ABSTRACT
There is an ongoing debate whether gender
differences in the dimensions of the knee
should impact the design of TKA components.
Our hypothesis was that not only gender, but
also the patient’s morphotype may determine
the shape of the distal femur and proximal
tibia, and that this factor should be taken into
account when designing gender specific TKA
implants.
Exactly 1000 consecutive patients undergoing
TKA were therefore studied and stratified into
three groups based upon their anatomic consti-
tution; 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 size
knees, female knees were significantly more
narrow than male knees. Patients with smaller
knees (predominantly female) demonstrated
large variability between narrow and wide
mediolateral dimensions, irrespective of gen-
der. The same was true for larger knees (pre-
dominantly 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, while patients with long and nar-
row morphotype (ectomorph) had more nar-
row knees.
The shape of the knee is therefore not only
dependent on gender, but also on the morpho-
type of the patient.
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