SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2022
Sexual dimorphism and racial diversity render bone-implant mismatch inevitable after off-the-shelf total knee arthroplasty: a systematic review and meta-analysis.
Synthesis in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
16 citing papers in PubMed, 25 citations in OpenAlex.
- Individualised total knee arthroplasty demonstrates 99.4% survival at 3 to 5 years.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Observational
- Differences in characteristic morphological variability among distal femurs based on sex and ethnicity.Bone & joint open · 2026Article
- Virtual cutting-based morphological differences in osteoarthritic and healthy knees: Implications for total knee arthroplasty prosthesis design.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2025Observational
- How New Technologies Will Transform Total Knee Arthroplasty from a Singular Surgical Procedure to a Holistic Standardized Process.Journal of clinical medicine · 2025Article
- Increased implant thickness in mechanically aligned off-the-shelf total knee replacement compared to bone resection.Journal of experimental orthopaedics · 2025Article
- [New technologies in total knee arthroplasty : Current concepts and personalized treatment strategies].Orthopadie (Heidelberg, Germany) · 2025Review
- Why personalized surgery is the future of hip and knee arthroplasty: a statement from the Personalized Arthroplasty Society.EFORT open reviews · 2023Review
- Five or more gender- and size-diverse customizations of distal femur prostheses are needed to improve fit for Chinese knees.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Satisfaction after total knee arthroplasty: a prospective matched-pair analysis of patients with customised individually made and off-the-shelf implants.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Definitions and consequences of current alignment techniques and phenotypes in total knee arthroplasty (TKA) - there is no winner yet.Journal of experimental orthopaedics · 2023Review
- Medial meniscus tears are most prevalent in type I ACL tears, while type I ACL tears only account for 8% of all ACL tears.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Custom total knee arthroplasty combined with personalised alignment grants 94% patient satisfaction at minimum follow-up of 2 years.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Personalisation and customisation in total knee arthroplasty: the paradox of custom knee implants.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Physiological Femoral Condylar Morphology in Adult Knees-A MRI Study of 517 Patients.Diagnostics (Basel, Switzerland) · 2023Article
- The Morphology of a Kinematically Aligned Distal Femoral Osteotomy Is Different from That Obtained with Mechanical Alignment and Could Have Implications for the Design of Total Knee Arthroplasty.Journal of personalized medicine · 2022Article
- Biomechanical Effects of Aspect Ratio of the Knee during Outside-In Anterior Cruciate Ligament Reconstruction Surgery.BioMed research international · 2021Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of this systematic review and meta-analysis was to investigate the variability in femoral geometric ratios among knees of different sexes and races, and to appreciate whether the observed variability is accommodated by commonly implanted total knee arthroplasty (TKA) components. The hypothesis was that the anthropometric studies report considerable variability of femoral geometric ratios among sexes and races.
methodsThis systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) criteria. Two authors independently conducted an electronic search using MEDLINE
resultsA total of 15 studies were identified that reported on a combined total of 2627 knees; all reported the aspect ratio, and 2 also reported the asymmetry ratio and trapezoidicity ratio. Men had wider knees than women, and compared to Caucasian knees, Arabian and Indian knees were wider, while East Asian were narrower. There were no differences in asymmetry ratio between men and women, nor among Caucasian and East Asian knees. Men had more trapezoidal knees than women, and East Asian knees were more trapezoidal than Caucasian knees. The commonly implanted femoral components accommodated less than a quarter of the geometric variability observed among sexes and races.
conclusionAnthropometric studies reported considerable sexual dimorphism and racial diversity of femoral geometric ratios. Since a surgeon generally only uses one or a few TKA brands, bone-implant mismatch remains unavoidable in a large proportion of knees. These findings support the drive towards personalized medicine, and accurate bone-implant fit may only be achievable through customisation of implants, though the clinical benefits of custom TKA remain to be confirmed. LEVEL OF EVIDENCE: IV.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.