Date Published: August 30, 2012
Publisher: Hindawi Publishing Corporation
Author(s): Ioannis Terzidis, Trifon Totlis, Efthymia Papathanasiou, Aristotelis Sideridis, Konstantinos Vlasis, Konstantinos Natsis.
The purpose of the present study was to conduct direct measurements in a large sample of dried femori in order to record certain morphometric parameters of the femoral condyles and determine whether there are gender and side differences. Three hundred sixty (Greek) Caucasian dried femori (180 left and 180 right), from 192 males and 168 females, were measured using a digital caliper. The mean age was 67.52 years. The mean bicondylar width of the femur was 8.86 cm ± 0.42 cm in men and 7.85 cm ± 0.30 cm in women (P < 0.01). The relative values for the medial condylar depth were 6.11 cm ± 0.34 cm and 5.59 cm ± 0.29 cm (P < 0.05); for the lateral condylar depth were 6.11 cm ± 0.33 cm and 5.54 cm ± 0.21 cm (P < 0.01); for the intercondylar width were 2.20 cm ± 0.18 cm and 1.87 cm ± 0.10 cm (P < 0.001); for the intercondylar depth were 2.78 cm ± 0.16 cm and 2.37 cm ± 0.12 cm (P < 0.001). No significant side-to-side difference was observed in any parameter. The femoral condyles differences in anatomy between genders might be useful to the design of total knee prostheses. The contralateral healthy side can be safely used for preoperative templating since there were no significant side differences.
Quantitative anatomy of the distal femur is important for the design of total joint replacement and internal fixation material. Recent studies emphasize on differences between genders and among ethnic groups [1–5]. Preoperative templating for a total knee arthroplasty usually involves the contralateral, healthy side, based on the assumption that there are no side-to-side differences . Furthermore, it has been found that certain osteometric parameters of the femur, such as the femoral intercondylar notch width, differ between genders and are associated with both the volume and the incidence of anterior cruciate ligament (ACL) rupture [7–9]. However, this association has been questioned by other researchers [10, 11].
The sample consisted of 360 paired dried femori (180 left and 180 right) from 192 males and 168 females. The mean age was 67.52 years (range 40–94 years). Femori that belonged to individuals other than Greeks were excluded. Femori that on gross inspection had evidence of fracture, post-mortem damage or arthritis were excluded from the study, as well. All measurements were performed with a digital sliding caliper. The osteometric parameters were defined as follows: (1) bicondylar width: the maximum distance across the femoral condyles in the transverse plane (Figure 1); (2) medial condylar depth: the maximum anteroposterior diameter of the medial femoral condyle (Figure 2); (3) lateral condylar depth: the maximum anteroposterior diameter of the lateral femoral condyle; (4) intercondylar notch width: the distance between 1/2 the anteroposterior diameter of the lateral surface of the medial femoral condyle and 1/2 the anteroposterior diameter of the medial surface of the lateral femoral condyle (Figure 3); (5) intercondylar notch depth: the vertical distance between the most anterior point of the inferior border of the intercondylar notch and the tangent to the posterior surface of the femoral condyles (Figure 4).
The mean bicondylar width of the femur was 8.39 cm ± 0.63 cm (range, 7.15 cm–9.42 cm). It was 8.86 cm ± 0.42 cm (range, 7.83 cm–9.42 cm) in men and 7.85 cm ± 0.30 cm (range, 7.15 cm–8.20 cm) in women (P < 0.01). The mean medial condylar depth was 5.87 cm ± 0.41 cm (range, 5.12cm–6.60 cm). The relative values for the medial condylar depth in men were 6.11 cm ± 0.34 (range, 5.23 cm–6.60 cm) and in women were 5.59 cm ± 0.29 cm (range, 5.12 cm–6.01 cm) (P < 0.05). The average lateral condylar depth was 5.85 ± 0.40 (range, 5.11 cm–6.60 cm). It was 6.11 cm ± 0.33 cm (range, 5.32 cm–6.60 cm) in men and 5.54 cm ± 0.21 cm (range, 5.11 cm-5.98 cm) in women (P < 0.01). The mean intercondylar width was found 2.05 cm ± 0.22 cm (range, 1.60 cm–2.64 cm). In male femora average value was 2.20 cm ± 0.18 cm (range, 1.89 cm–2.64 cm) and in female femora was 1.87 cm ± 0.10 cm (range, 1.60 cm–2.12 cm) (P < 0.001). The intercondylar depth was 2.59 cm ± 0.20 cm on average (range, 2.32 cm–3.10 cm). It was 2.78 cm ± 0.16 cm (range, 2.47 cm–3.10 cm) and 2.37 cm ± 0.12 cm (range, 2.32 cm–2.76 cm) (P < 0.001). Data, as well as measurements error values, are summarized in Tables 1, 2, 3, 4, and 5. In the present study, five morphometric parameters were recorded in dried bones with a direct method using digital sliding caliper. In the literature most anatomic morphometric studies have been conducted with indirect methods including radiography, computerized tomography, magnetic resonance imaging, and 3D modelling. Given the fact that cadaveric material is scarce, these methods offer the advantage of describing anatomy in large samples since they can be performed in living subjects. However, indirect methods have been found to be inaccurate even after correction for magnification, technique, and projection [14–16]. Source: http://doi.org/10.1155/2012/679658