A1127. GENDER-SPECIFIC DESIGN IN TOTAL KNEE ARTHROPLASTY – RARELY NECESSARY FOR KOREAN WOMEN

Abstract

The purpose of this prospective study was to investigate the necessity of gender-specific design in total knee arthroplasty (TKA) for Korean women.

One hundred and seventeen women (151 knees) who underwent primary TKA by one surgeon with Nexgen^® LPS (Zimmer, Warsaw, IN) were evaluated. The mean age was 70 (range 52–80) years. The size of the implant was determined by considering anteroposterior (AP) dimension and the amount of posterior condylar resection. Size C was used in 72 knees, size D in 57 and size E in 22. We measured the mediolateral (ML) widths of distal femur at four points (anterior, distal anterior, distal posterior, posterior) intraoperatively after bone cutting, and compared them with the ML widths of the corresponding femoral implants. The ML/AP ratio was calculated in each size group.

The mean ML widths of the distal femur checked at all four points were larger than those of the implants. The ML/AP ratio of the distal femur decreased as the size increased from C to E, especially that of the anterior point. Overhanging occurred in 7 cases (4.6%, size C -2 cases, size D -2 cases, E -3 cases) : Nexgen^® LPS implant was used in 5 cases because there was only minimal antero-lateral overhanging, resulting in no postoperative problem such as pain or limited motion. Gender-specific design was used in only 2 cases (1.3%, size D -1 case, size E -1 case) with trochlear dysplasia due to general overhanging.

In conclusion, gender-specific design of Nexgen^® TKA was rarely necessary in 117 Korean women(151 knees); overhanging occurred in 7 knees (6 women) and gender-specific design was used in only two knees (1.3%) with trochlear dysplasia. Further research is obviously mandatory to assess the necessity of gender-specific design.