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Gender Specific High Flex Knee replacement

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Since 60 percent of patients ungergoing a knee replacement are women, it makes sense to have a specially designed implant for the female anatomy. The Gender specific knee implant is an unique prosthesis designed for women's anatomy. Women with bilateral knee replacements one with a tradiitonal knee and the other with a gender knee state that they are more comfortable with the gender knee.

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Gender Specific High Flex Knee replacement

  1. 1. Gender specific High flex knee replacement Dr.A.K.Venkatachalam MS, DNB, FRCS, MCh Orth www.kneeindia.com
  2. 2. Knee replacement – basic facts <ul><li>Nearly 30000 people undergo joint replacements in India per year with a 25% increase each year. </li></ul><ul><li>Knee osteoarthritis is the commonest indication for joint replacement. </li></ul><ul><li>Two thirds of population undergoing a TKR are women. </li></ul>
  3. 3. Requirements for TKR <ul><li>Arthritis, injuries, infection cause deterioration of cartilage causing bone to grind on bone leading to severe pain. </li></ul><ul><li>Historically implants for TKR have been designed based upon an average between the size of women’s and men’s knees. </li></ul>
  4. 4. Knee replacements- Implant features so far <ul><li>Knee implants come in various sizes </li></ul><ul><li>Merely using a different size does not address the shape differences. </li></ul>
  5. 5. Short comings of using Non gender specific knees <ul><li>Even though most women are happy with their results after TKR, some still have residual pain in the front of the knee around the knee cap </li></ul><ul><li>Or they say their artificial knee doesn’t feel or move the way of their own knee when it was healthy. </li></ul>
  6. 6. Gender differences between men and women <ul><li>Women are not smaller versions of men </li></ul><ul><li>They are shaped differently </li></ul><ul><li>Although Women can wear men’s clothes and shoes, they prefer to wear specially designed apparel. </li></ul><ul><li>Total knee replacement (TKR) involves resurfacing the worn out ends with metal and plastic implants. </li></ul><ul><li>Differences in bones, ligaments and tissues of men & women </li></ul>
  7. 7. Structure of the knee joint <ul><li>Composed of three bones </li></ul><ul><li>lower end of the femur( thigh bone) </li></ul><ul><li>Upper end of the leg bone( tibia) </li></ul><ul><li>Knee cap( patella) </li></ul><ul><li>All the bones are held together by tendons and ligaments and cushioned by cartilage. </li></ul>
  8. 8. Gender specific knee Two distinct populations: women and men <ul><li>Two distinct populations: women and men </li></ul><ul><li>Pioneering research conducted by Zimmer has mapped the anatomical differences between </li></ul><ul><li>Female and male knees laying the foundation for the design and development of gender solutions high-flex femoral implants. </li></ul><ul><li>Three-dimensional CT data was collected and analyzed for more than 800 femurs and patellas. </li></ul><ul><li>Significant differences were identified between female and male knee anatomy. </li></ul><ul><li>Plotting M/L and A/P dimensions of the distal femur reveals two distinct populations: female and male. </li></ul><ul><li>Implant designs that distinguish between female and male anatomical differences allow for improved implant fit and fewer intraoperative adjustments.Gender solutions high-flex femoral implants address the distinctive differences typically found in the female anatomy. </li></ul><ul><li>Pioneering research conducted by Zimmer has mapped the anatomical differences between Female and male knees, laying the foundation for the design and development of gender solutions high-flex femoral implants. </li></ul><ul><li>Three-dimensional CT data was collected and analyzed for more than 800 femurs and patellas. </li></ul>
  9. 9. Gender specific knee <ul><li>Significant differences were identified between female and male knee anatomy. </li></ul><ul><li>Plotting M/L and A/P dimensions of the distal femur reveals two distinct populations: female and male. </li></ul><ul><li>Implant designs that distinguish between female and male anatomical differences allow for improved implant fit and fewer intraoperative adjustments.. </li></ul>
  10. 10. Gender specific knee <ul><li>Gender solutions high-flex femoral implants address the distinctive differences typically found in the female anatomy. </li></ul><ul><li>Historically we have shaped the patients to fit the implants. Now we have implants shaped to fit the patients.” </li></ul>
  11. 11. Gender specific knee <ul><li>Anterior Flange Thickness </li></ul><ul><li>Research has shown that the female knee has a less-pronounced anterior condyle than males. This less-pronounced anterior condyle results in less bone being resected from the female knee: </li></ul><ul><li>0.8mm less on the lateral condyle (p < 0.02).13 </li></ul><ul><li>1.3mm less on the medial condyle (p < 0.01).13 </li></ul><ul><li>Gender Solutions High-Flex Femoral Implants address the distinctive anterior condyle differences by: </li></ul><ul><li>Reducing the anterior flange thickness of the implant. </li></ul><ul><li>Recessing the patellar sulcus. </li></ul><ul><li>Retaining the clinically successful NexGen patellar articulation. </li></ul><ul><li>Avoiding overstuffing that may limit postoperative range of motion 14,15 that can occur when placing a traditional implant on a resected female knee. </li></ul><ul><li>when placing a traditional implant on a resected female knee. </li></ul>
  12. 12. <ul><li>Anterior Flange Width </li></ul><ul><li>The femoral anterior resection of the female bone is narrower than the male femoral anterior resection. </li></ul>
  13. 13. Gender specific knee <ul><li>Increased Trochlear Groove Angle </li></ul><ul><li>Patellar maltracking remains a concern —particularly with females —following total knee arthroplasty.5 </li></ul><ul><li>Research documents that women have a statistically significant higher Q-angle than men.6,7,8 </li></ul><ul><li>Gender Solutions High-Flex Femoral Implants replicate the distinct Q-angle difference by increasing the trochlear groove angle of the implant three degrees </li></ul>
  14. 15. Gender specific knee <ul><li>CT data documents distinctive shape differences in female and male distal femurs.12,13 Female femurs are: </li></ul><ul><li>More trapezoidal-shaped. </li></ul><ul><li>Narrower in the M/L dimension when compared to a male femur of the same A/P dimension </li></ul><ul><li>When a traditional implant is placed onto a resected female knee: </li></ul><ul><li>The implant may overhang the bone at the distal, anterior, and posterior M/L interfaces, which may lead to soft-tissue irritation and affect soft-tissue </li></ul><ul><li>balancing.1,3,4 </li></ul><ul><li>The surgeon may be faced with intra-operative adjustments to compensate for the overhang. </li></ul><ul><li>Gender Solutions High-Flex Femoral Implants have been narrowed medio-laterally. </li></ul><ul><li>This allows surgeons to address the female population with unprecedented accuracy. </li></ul>
  15. 17. Gender specific knee <ul><li>Femoral Mapping—Applying the Science </li></ul><ul><li>To address the issue of overhang in female knee arthroplasty, Zimmer has devised a unique patent pending method for predetermining the contour of a resected bone and the fit of an implant on the bone, and applied this novel method in its development of the Gender Solutions High-Flex Femoral Implant. </li></ul><ul><li>A traditional implant overhangs female bone as shown in red. </li></ul><ul><li>Zimmer Gender Solutions High-Flex implant on female bone shows little to no overhang as shown in the lower model. </li></ul>
  16. 20. Salient features of Gender specific knee <ul><li>More natural movement </li></ul><ul><li>Thinner profile – so that the knees will not feel bulky and cause less pain and increase function </li></ul><ul><li>Contoured shape to match more closely the narrower anatomy of the female knee. This provides for a more precise fit and prevent overhanging the bone and press and damage surrounding ligaments and tendons. </li></ul>
  17. 21. Advantages <ul><li>Allows full knee bending or flexion upto 155 degrees which is necessary for activities like sitting on a low chair or on the floor, climbing stairs, gardening </li></ul><ul><li>Can be placed with Minimally invasive solutions procedures which typically offer smaller scars, shorter hospitalization and quicker recovery. </li></ul>
  18. 22. Minimally invasive high flex TKR
  19. 23. Patients squatting after High flexion TKR
  20. 24. www.kneeindia.com Thank you

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