ABSTRACT
Our study aimed to introduce an automatic three-dimensional method for measuring the
distal femur and identifying potential gender differences and the effects on femoral
component placement in total knee arthroplasty. Three hundred forty-two femora were
scanned with computed tomography. Automatic and manual bone resection and component
placement were compared using a virtual resection tool. For standard component use,
77.3% of the femora were male and 23.1% were female. For gender-specific component
use, 91% were female and 7.3% were male. Surgeon errors in both component translation
and rotation existed but were minimal. From these results, gender alone did not dictate
component use in primary total knee arthroplasty. The restoration of femoral condylar
profile in 3 dimensions can be obtained by accurately measuring patient distal femoral
anatomy and the appropriate femoral component design selection. Additional bone cuts,
soft-tissue maneuvers, and adverse outcomes in fitting the patient to the femoral
component may be avoided.
