Morphometric analysis of the adult knee and its correlation with current knee arthroplasty systems

Samuel Frank Stephen, (2013) Morphometric analysis of the adult knee and its correlation with current knee arthroplasty systems. Masters thesis, Christian Medical College, Vellore.

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Abstract

INTRODUCTION: Osteoarthritis is a degenerative joint disorder commonly affecting the knees, which is now being treated often by total knee replacement. Success of total knee replacement surgery depends a lot upon the choice of the knee prosthesis. Many studies amongst other population groups have shown the need for a race and gender specific knee prostheses. However, there is scanty literature on the morphometry of the normal adult Indian knee with relevance to knee replacement. The currently used knee arthroplasty systems for total knee replacement in India are based on morphometric patterns of Western population. There is a need therefore, to improve the design and kinematics of knee prosthesis available in India in order to duplicate patient anatomy more closely. In order to fulfill this need, the initial step would be to have comprehensive morphometric data on non-osteoarthritic Indian knees. OBJECTIVES: 1. To measure the dimensions of distal femur, proximal tibia and patella in the Indian population by collecting data from cadaveric knees and dry bones and to obtain the fraction ‘Aspect ratio’. 2. To compare these dimensions between male and female specimens to identify gender differences. 3. To compare the morphometric dimensions with other racial groups and with current knee arthroplasty systems in India METHODS: Dissection of the knee joint was done on fourteen adult cadavers (8 female and 6 male) and measured. The dry bones measured were181 femurs and 161 tibias. All the data was entered into Excel workbook sheets (Microsoft Office Excel; version 2007, Microsoft ® Corporation, US.) and analysed using SPSS (version 17.0; SPSS Inc., Chicago, IL). The statistical analyses done were measures of dispersion, bivariate correlation analysis and liner regression analysis. Student’s "t" test for equality of means was performed to determine if the morphological measurements were statistically different between sexes, The Interclass Correlation (ICC) test was used for assessing Rater Reliability. RESULTS: In the dry bones Aspect ratio for the distal femur was 1.29 ± 0.1 and for the proximal tibia was 1.52 ± 0.18. • In the cadaveric data Aspect ratio for the distal was 1.27 ± 0.4 and for the proximal tibia was 1.48 ± 0.2. • On comparing the morphometry of the distal femur and proximal tibia between the two genders it was found that the measurements were significantly more in males than in females. • On comparing with other racial groups the dimensions of the distal femur were smaller as compared to the Caucasian and other Asian races. No such differences were found while comparing the dimensions of the proximal tibia. • The femoral component of the present knee arthroplasty systems that were considered in this study significantly differed from the distal femoral dimensions obtained whereas the tibial component correlated well with the bone dimensions obtained in this study. • On comparing with other racial groups the dimensions of the distal femur were smaller as compared to the Caucasian and other Asian races. No such differences were found while comparing the dimensions of the proximal tibia. • The femoral component of the present knee arthroplasty systems that were considered in this study significantly differed from the distal femoral dimensions obtained whereas the tibial component correlated well with the bone dimensions obtained in this study. CONCLUSIONS: Hence it can be suggested that there is a need for redesign of the present knee arthroplasty systems incorporating the different dimensions of the distal femur and the gender differences as measured in the Indian population in this study.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Morphometric analysis, adult knee, current knee arthroplasty systems.
Subjects: MEDICAL > Anatomy
Depositing User: Subramani R
Date Deposited: 05 Oct 2019 13:51
Last Modified: 05 Oct 2019 13:51
URI: http://repository-tnmgrmu.ac.in/id/eprint/11700

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