Termizi, Nur Syahida Mohd
(2018)
Anthropometric intraoperative measurement of the patella dimensions in total knee arthroplasty of female patients.
Masters thesis, Universiti Sains Malaysia.
Abstract
Background: Patellofemoral joint is considered as a complex joint involving articulation between
the patella and femoral trochlea. Loss of patella articular cartilage occurs in patellofemoral arthritis
that may require patella arthroplasty in Total Knee Arthroplasty (TKA). Proper patella implant sizing
is important to prevent implant failure. However implants used for TKA in Asian patients mostly
produced based on anthropometry of the Western population. We conducted this study to define
intra-operative anatomy of patella dimensions in our populations and compare it with current
prosthetic systems.
Methods: This was a cross sectional study involving female patients who underwent Total Knee
Arthroplasty in HUSM. Intra-operative anatomic measurements of 78 patellae with normal
underlying bony structure were studied. Patella was measured using a surgical caliper which had
sensitivity up to 0.5 mm. Patella dimensions that were measured including the patella height, width,
thickness, medial and lateral articular facets width and thickness and patella circumference. Smallest
implant size from 3 manufacturers were measured. Analysis using descriptive statistics was used to
get the mean and median of anatomical patella dimensions, whereas Independent T test and One-
Way ANOVA test were used to compare the female Malaysian patella dimensions with current
prosthesis system sizing.
Results: The articular surface of the patella was found to have an oval shape with a width-height
ratio of 1.31. The mean patella thickness, width and height were 20.7 mm, 40.7 mm and 31.3 mm
respectively. Only 17.9% fit for smallest implant size from all 3 companies while 57.6% did not fit
for all implants. Oval-shape implant was suitable in 53.8% patients while another 46.2% were
suitable for round-shape implant based on their width-height ratio.
Conclusions: Our female patients have thinner and smaller patella which accommodate smaller
patellar components than the Westerners. Therefore, the orthopaedic implant manufacturers have to
consider optimizing the thicknesses as well as widths of their patellar prostheses.
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