Volume 3, Issue 4, July 2015, Page: 67-72
Comparison Between Standard and Gender-Specific Knee Designs in Total Knee Arthroplasty in Female Patients
Elsayed Morsey Zaki, Department of Orthopedic surgery, Faculty of medicine, Menoufia University, Menoufia, Egypt
Tarek Ali Elkhadrawe, Department of Orthopedic surgery, Faculty of medicine, Alexandria University, Alexandria, Egypt
Ayman Mohammed Ebied, Department of Orthopedic surgery, Faculty of medicine, Menoufia University, Menoufia, Egypt
Amro Saber Elsayed, Department of Orthopedic surgery, Faculty of medicine, Menoufia University, Menoufia, Egypt
Hany Elsayed Saad, Department of Orthopedic surgery, Faculty of medicine, Menoufia University, Menoufia, Egypt
Received: May 15, 2015;       Accepted: May 29, 2015;       Published: Jun. 14, 2015
DOI: 10.11648/j.ajss.20150304.11      View  4330      Downloads  100
Abstract
Objectives: Current study is a comparative, prospective, randomized, short-term outcome study to compare the early results of Total Knee Arthroplasty in female patients using either standard or gender-specific knee prosthesis for treatment of advanced osteoarthritis of the knee joint. Background: Gender-specific knee athroplasty prosthesis is designed to better accommodate the differences noted in distal femoral anatomy in female patients compared to males. Several studies have reported differences in knee morphometry between genders such as the height/width ratio of the distal femoral condyle, the quadriceps angle and the shape of the distal femur. The need for Gender-specific (GS) femoral prostheses is still debated and has led us to compare short-term outcomes of TKA using standard (STD) or GS femoral components. Methods: In the period between February 2012 and February 2013, a comparative prospective randomized study was conducted involving 34 female patients with 40 knees who underwent primary total knee arthroplasty for knee joint advanced osteoarthritis and divided into two groups , The first group included 20 knees underwent total knee arthroplasty using Gender-Specific Knee Design with Gender-Specific femoral component (Zimmer Gender Solutions NexGen High-Flex ( NexGen LPS-Flex ) Implant , The second group included 20 knees underwent total knee arthroplasty using standard Knee Design with Standard femoral component (Zimmer NexGen LPS Implant). Results: No statistically significant differences were observed between the two groups regarding pain improvement, range of motion improvement, pre and post operative OXFORD scores, Knee Society Scores, WOMAC scores, satisfaction, preference, complications, and radiographic results. Conclusion: Early clinical outcomes for the knees with a gender-specific NexGen LPS-Flex prosthesis were similar to those for the knees with a standard NexGen LPS prosthesis in female patients. gender-specific knee prosthesis showed no advantages over standard unisex knee prosthesis in terms of early clinical outcomes.
Keywords
Gender, Gender-Specific, Arthroplasty, Knee
To cite this article
Elsayed Morsey Zaki, Tarek Ali Elkhadrawe, Ayman Mohammed Ebied, Amro Saber Elsayed, Hany Elsayed Saad, Comparison Between Standard and Gender-Specific Knee Designs in Total Knee Arthroplasty in Female Patients, American Journal of Sports Science. Vol. 3, No. 4, 2015, pp. 67-72. doi: 10.11648/j.ajss.20150304.11
Reference
[1]
Rand JA, Trousdale RT, Ilstrup DM, Harmsen WS: Factors affecting the durability of primary total knee prostheses. J Bone Joint Surg Am 2003;85-A:259-265
[2]
Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KD (2010) Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? Clin Orthop Relat Res 468(1):57–63
[3]
Hawker GA, Wright JG, Coyte PC, et al: Differences between men and women in the rate of use of hip and knee arthroplasty. N Engl J Med 2000; 342:1016-1022.
[4]
Rand JA, Ilstrup DM .Survivorship analysis of total knee arthroplasty: cumulative rates of survival of 9200 total knee arthroplasties. J Bone Joint Surg [Am] (1991). 73-A:397–409
[5]
Ritter MA, Wing JT, Berend ME, Davis KE, Meding JB (2008) The clinical effect of gender on outcome of total knee arthroplasty. J Arthroplast 23:331–336
[6]
Font-Rodriguez DE, Scuderi GR, Insall JN. Survivorship of cemented total knee arthroplasty. Clin Orthop 1997; 345:79.
[7]
Conley S, Rosenberg A, Crowninshield R. The female knee: anatomic variations. J Am Acad Orthop Surg. 2007; 15(suppl1):S31–S36.
[8]
Hitt K, Shurman JR II, Greene K, et al: Anthropometric measurements of the human knee: Correlation to the sizing of current knee arthroplasty systems. J Bone Joint Surg Am 2003; 85(suppl 4):115-122.
[9]
Lonner JH, Jasko JG, Thomas BS. Anthropomorphic differences between the distal femora of men and women. Clin Orthop Relat Res. 2008; 466:2724–2729.
[10]
Fehring TK, Odum SM, Hughes J, Springer BD, Beaver Jr WB. Differences between the sexes in the anatomy of the anterior condyle of the knee. J Bone Joint Surg Am 2009; 91:2335–41.
[11]
Booth RE Jr. Sex and the total knee: gender-sensitive designs. Orthopedics. 2006; 29:836–838.
[12]
Greene Kenneth A. Gender-Specific Design in Total Knee Arthroplasty 2007 The Journal of Arthroplasty Vol. 22 No. 7 :27-31
[13]
MacDonald SJ, Charron KD, Bourne RB, Naudie DD, McCalden RW,Rorabeck CH: The John Insall Award: gender-specific total knee replacement: prospectively collected clinical outcomes. Clin Orthop RelatRes 2008, 466:2612-2616
[14]
.Merchant A C, Arendt E A, Dye S F, Fredericson M, Grelsamer R P, Leadbetter W B, Post W R, Teitge R A. The female knee: anatomic variations and the female-specific total knee design. Clin Orthop 2008; (466) (12): 3059-65.
[15]
Dalury D F, Mason J B, Murphy J A, Adams M J. Analysis of the outcome in male and female patients using a unisex total knee replacement system. J Bone Joint Surg (Br) 2009; 91 (3): 357-60.
[16]
Johnson A J, Costa C R, Mont M A. Do we need gender-specific total joint arthroplasty? Clin Orthop 2011; (469) (7): 1852-8.
[17]
O’Connor M I. Implant survival, knee function, and pain relief after TKA: are there differences between men and women?” Clin Orthop 2011; (469) (7): 1846-51.
[18]
Parsley B S, Bertolusso R, Harrington M, Brekke A, Noble P C. Influence of gender on age of treatment with TKA and functional outcome. Clin Orthop 2010; (468) (7): 1759-64.
[19]
Bellemans J, Carpentier K, Vandenneucker H, et al. The John Insall Award: both morphotype and gender influence the shape of the knee in patients undergoing TKA. Clin Orthop Relat Res. 2010; 468:29–36.
[20]
Cheng CK, Liau JJ. Morphometrical measurements of resected surface of femurs in Chinese knees: correlation to the sizing of current femoral implants. Knee 2006; 13:12.
[21]
Kim Y H, Choi Y, Kim J S. Comparison of a standard and a gender-specific posterior cruciate-substituting high-flexion knee prosthesis: a prospective, randomized, short-term outcome study. J Bone Joint Surg (Am) 2010 a; 92 (10): 1911-20.
[22]
Kim Y H, Choi Y, Kim J S. Comparison of standard and gender-specific posterior-cruciate-retaining high-flexion total knee replacements: a prospective,randomised study. J Bone Joint Surg (Br) 2010 b; 92 (5): 639-645.
[23]
Kumar V, Bhavuk G, Malhotra R. A randomized trial comparing gender specific with gender non-specific knee arthroplasty implants.J Bone Joint Surg (Br) 2012; 94: 525.
[24]
Singh H, Mittal V, Nadkarni B, Agarwal S, Gulati D. Gender-specific highflexion knee prosthesis in Indian women: a prospective randomised study.J Orthop Surg (Hong Kong) 2012; 20 (2): 153-6.
[25]
Song E K, Jung W B, Yoon T R, Park K S, Seo H Y, Seon J K. Comparison of outcomes after bilateral simultaneous total knee arthroplasty using genderspecific and unisex knees. J Arthroplasty 2012; 27 (2): 226-31.
[26]
Thomsen M G, Husted H, Bencke J, Curtis D, Holm G, Troelsen A. Do we need a gender-specific total knee replacement? A randomised controlled trial comparing a high-flex and a gender-specific posterior design. J Bone Joint Surg (Br) 2012; 94 (6): 787-92.
[27]
Tanavalee A, Rojpornpradit T, Khumrak S, Ngarmukos S (2011) The early results of gender-specific total knee arthroplasty in Thai patients. Knee 18(6):483–487
[28]
Clarke H D, Hentz J G. Restoration of femoral anatomy in TKA with unisex and gender-specific components. Clin Orthop 2008; (466) (11): 2711-6.
[29]
Yan M, Wang J, Wang Y, Zhang J, Yue B, Zeng Y. Gender-based differences in the dimensions of the femoral trochlea and condyles in the Chinese population: Correlation to the risk of femoral component overhang. Knee 2014; 21(1):2 52-6.
[30]
Mahoney O M, Kinsey T. Overhang of the femoral component in total knee arthroplasty: risk factors and clinical consequences. J Bone Joint Surg (Am) 2010; 92 (5): 115-21.
Browse journals by subject