Allograft or synthetic menisci have been suggested as a means to restore contact pressures following meniscectomy. However, when the natural meniscus is severely damaged/absent, the necessary size cannot be determined according to the recipient size and there is a need to estimate it from magnetic resonance imaging (MRI) of the contralateral knee or the injured knee bones. The use of the contralateral-knee for size matching is problematic due to economic and practical reasons. Hence, there are significant advantages for a sizing algorithm based only on the candidate knee geometry. The aim of this study is to characterize midrange values and variability of knee dimensions and to develop a set of mathematical relations representing knee dimensions using a minimum of imaging-based bone measurements. Tibia, femur, and meniscus measurements were taken in 118 MRI scans and used to develop a representative parametric knee model in which all dimensions are expressed using tibia plateau width. The model was verified by comparing the predicted values to direct MRI measurements for 20 additional subjects by means of the Pearson correlation and Bland and Altman (1986, “Statistical Methods for Assessing Agreement Between Two Methods of Clinical Measurement,” Lancet, 1, pp. 307–310) plot. Anatomical parameters in the male knee were significantly larger (17%) compared with corresponding female measurements. However, most relations between tibia, femur, and meniscus measurements (43/56) were not significantly different between male and female populations (p0.05), indicating that differences between male and female joints are generally related to scaling and not shape. Dimensions predicted by the knee model were in a good agreement with dimensions measured directly from the MRI (R2>0.96) and the Bland and Altman plot indicated that 95% of data points were well within the ±2 standard deviation lines of agreement. The model proposed in this study is advantageous in being able to describe typical knee proportions for a given tibial width and can be used to predict the dimensions of a candidate knee based on a single measurement. The anatomical/anthropometric data presented in the study can be utilized in a sizing algorithm for artificial meniscal implants or in the design of artificial meniscus prostheses.

1.
Radin
,
E. L.
,
de Lamotte
,
F.
, and
Maquet
,
P.
, 1984, “
Role of the Menisci in the Distribution of Stress in the Knee
,”
Clin. Orthop. Relat. Res.
0009-921X,
185
, pp.
290
294
.
2.
Haut Donahue
,
T. L.
,
Hull
,
M. L.
,
Rashid
,
M. M.
, and
Jacobs
,
C. R.
, 2004, “
The Sensitivity of Tibiofemoral Contact Pressure to the Size and Shape of the Lateral and Medial Menisci
,”
J. Orthop. Res.
0736-0266,
22
, pp.
807
814
.
3.
Voloshin
,
A. S.
, and
Wosk
,
J.
, 1983, “
Shock Absorption of Meniscectomized and Painful Knees: A Comparative In Vivo Study
,”
J. Biomed. Eng.
0141-5425,
5
, pp.
157
161
.
4.
Hsieh
,
H. H.
, and
Walker
,
P. S.
, 1976, “
Stabilizing Mechanisms of the Loaded and Unloaded Knee Joint
,”
J. Bone Jt. Surg., Am. Vol.
0021-9355,
58
, pp.
87
93
.
5.
Levy
,
I. M.
,
Torzilli
,
P. A.
, and
Warren
,
R. F.
, 1982, “
The Effect of Medial Meniscectomy on Anterior-Posterior Motion of the Knee
,”
J. Bone Jt. Surg., Am. Vol.
0021-9355,
64
, pp.
883
888
.
6.
Cox
,
J. S.
,
Nye
,
C. E.
,
Schaefer
,
W. W.
, and
Woodstein
,
I. J.
, 1975, “
The Degenerative Effects of Partial and Total Resection of the Medial Meniscus in Dogs’ Knees
,”
Clin. Orthop. Relat. Res.
0009-921X,
109
, pp.
178
183
.
7.
Allen
,
P. R.
,
Denham
,
R. A.
, and
Swan
,
A. V.
, 1984, “
Late Degenerative Changes After Meniscectomy: Factors Affecting the Knee After Operation
,”
J. Bone Joint Surg. Br.
0301-620X,
66
, pp.
666
671
.
8.
Milachowski
,
K. A.
,
Weismeier
,
K.
, and
Wirth
,
C. J.
, 1989, “
Homologous Meniscus Transplantation. Experimental and Clinical Results
,”
Int. Orthop.
0341-2695,
13
, pp.
1
11
.
9.
van Arkel
,
E. R.
, and
de Boer
,
H. H.
, 2002, “
Survival Analysis of Human Meniscal Transplantations
,”
J. Bone Joint Surg. Br.
0301-620X,
84
, pp.
227
231
.
10.
Noyes
,
F. R.
,
Barber-Westin
,
S. D.
, and
Rankin
,
M.
, 2004, “
Meniscal Transplantation in Symptomatic Patients Less Than Fifty Years Old
,”
J. Bone Jt. Surg., Am. Vol.
0021-9355,
86-A
, pp.
1392
1404
.
11.
Elliott
,
D. M.
,
Jones
,
R.
,
Setton
,
L. A.
,
Scully
,
S. P.
,
Vail
,
T. P.
, and
Guilak
,
F.
, 2002, “
Joint Degeneration Following Meniscal Allograft Transplantation in a Canine Model: Mechanical Properties and Semiquantitative Histology of Articular Cartilage
,”
Knee Surg. Sports Traumatol. Arthrosc
0942-2056,
10
, pp.
109
118
.
12.
McDermott
,
I. D.
,
Sharifi
,
F.
,
Bull
,
A. M.
,
Gupte
,
C. M.
,
Thomas
,
R. W.
, and
Amis
,
A. A.
, 2004, “
An Anatomical Study of Meniscal Allograft Sizing
,”
Knee Surg. Sports Traumatol. Arthrosc
0942-2056,
12
, pp.
130
135
.
13.
Dienst
,
M.
,
Greis
,
P. E.
,
Ellis
,
B. J.
,
Bachus
,
K. N.
, and
Burks
,
R. T.
, 2007, “
Effect of Lateral Meniscal Allograft Sizing on Contact Mechanics of the Lateral Tibial Plateau: An Experimental Study in Human Cadaveric Knee Joints
,”
Am. J. Sports Med.
0363-5465,
35
, pp.
34
42
.
14.
Blaha
,
J. D.
,
Mancinelli
,
C. A.
, and
Overgaard
,
K. A.
, 2009, “
Failure of Sex to Predict the Size and Shape of the Knee
,”
J. Bone Jt. Surg., Am. Vol.
0021-9355,
91
(
6
), pp.
19
22
.
15.
Erbagci
,
H.
,
Gumusburun
,
E.
,
Bayram
,
M.
,
Karakurum
,
G.
, and
Sirikci
,
A.
, 2004, “
The Normal Menisci: In Vivo MRI Measurements
,”
Surg. Radiol. Anat.
0930-1038,
26
, pp.
28
32
.
16.
Prodromos
,
C. C.
,
Joyce
,
B. T.
,
Keller
,
B. L.
,
Murphy
,
B. J.
, and
Shi
,
K.
, 2007, “
Magnetic Resonance Imaging Measurement of the Contralateral Normal Meniscus is a More Accurate Method of Determining Meniscal Allograft Size Than Radiographic Measurement of the Recipient Tibial Plateau
,”
Arthroscopy: J. Relat. Surg.
0749-8063,
23
, pp.
1174
1179.e1
.
17.
Haut
,
T. L.
,
Hull
,
M. L.
, and
Howell
,
S. M.
, 2000, “
Use of Roentgenography and Magnetic Resonance Imaging to Predict Meniscal Geometry Determined With a Three-Dimensional Coordinate Digitizing System
,”
J. Orthop. Res.
0736-0266,
18
, pp.
228
237
.
18.
Huang
,
A.
,
Hull
,
M. L.
,
Howell
,
S. M.
, and
Haut-Donahue
,
T.
, 2002, “
Identification of Cross-Sectional Parameters of Lateral Meniscal Allografts That Predict Tibial Contact Pressure in Human Cadaveric Knees
,”
ASME J. Biomech. Eng.
0148-0731,
124
, pp.
481
489
.
19.
Donahue
,
T. L.
,
Hull
,
M. L.
, and
Howell
,
S. M.
, 2006, “
New Algorithm For Selecting Meniscal Allografts That Best Match the Size and Shape of the Damaged Meniscus
,”
J. Orthop. Res.
0736-0266,
24
, pp.
1535
1543
.
20.
Ballyns
,
J. J.
,
Cohen
,
D.
,
Malone
,
E.
,
Maher
,
S. A.
,
Potter
,
H. G.
,
Wright
,
T. M.
,
Lipson
,
H.
, and
Bonassar
,
L. J.
, 2010, “
An Optical Method for Evaluation of Geometric Fidelity for Anatomically Shaped Tissue Engineered Constructs
,”
Tissue Eng. Part C Methods
,
16
(
4
), pp.
693
703
.
21.
Englund
,
M.
,
Guermazi
,
A.
,
Gale
,
D.
,
Hunter
,
D. J.
,
Aliabadi
,
P.
,
Clancy
,
M.
, and
Felson
,
D. T.
, 2008, “
Incidental Meniscal Findings on Knee MRI in Middle-Aged and Elderly Persons
,”
N. Engl. J. Med.
0028-4793,
359
, pp.
1108
1115
.
22.
Grigas
,
V.
,
Tutkus
,
V.
,
Tutkuvienë
,
J.
, and
Valionytë
,
L.
, 2005, “
Body Size Influence on Weight-Bearing Surface of the Knee
,”
Acta Medica Lituanica
,
12
, pp.
28
32
.
23.
Murshed
,
K. A.
,
Ciçekcibaşi
,
A. E.
,
Karabacakoğlu
,
A.
,
Seker
,
M.
, and
Ziylan
,
T.
, 2005, “
Distal Femur Morphometry: A Gender and Bilateral Comparative Study Using Magnetic Resonance Imaging
,”
Surg. Radiol. Anat.
0930-1038,
27
, pp.
108
112
.
24.
Bland
,
J. M.
, and
Altman
,
D. G.
, 1986, “
Statistical Methods for Assessing Agreement Between Two Methods of Clinical Measurement
,”
Lancet
0140-6736,
1
, pp.
307
310
.
25.
Rooney
,
N.
,
Fitzpatrick
,
D. P.
, and
Beverland
,
D. E.
, 2006, “
Intraoperative Knee Anthropometrics: Correlation With Cartilage Wear
,”
Proc. Inst. Mech. Eng., Part H: J. Eng. Med.
0954-4119,
220
, pp.
671
675
.
26.
Seedhom
,
B. B.
,
Longton
,
E. B.
,
Wright
,
V.
, and
Dowson
,
D.
, 1972, “
Dimensions of the Knee: Radiographic and Autopsy Study of Sizes Required by a Knee Prosthesis
,”
Ann. Rheum. Dis.
0003-4967,
31
, pp.
54
58
.
27.
Greene
,
K. A.
, 2007, “
Gender-Specific Design in Total Knee Arthroplasty
,”
J. Arthroplasty
0883-5403,
22
(
S3
), pp.
27
31
.
28.
Merchant
,
A. C.
,
Arendt
,
E. A.
,
Dye
,
S. F.
,
Fredericson
,
M.
,
Grelsamer
,
R. P.
,
Leadbetter
,
W. B.
,
Post
,
W. R.
, and
Teitge
,
R. A.
, 2008, “
The Female Knee: Anatomic Variations and the Female-Specific Total Knee Design
,”
Clin. Orthop. Relat. Res.
0009-921X,
466
, pp.
3059
3065
.
29.
Emerson
,
R. H.
, and
Martinez
,
J.
, 2008, “
Men Versus Women: Does Size Matter in Total Knee Arthroplasty?
,”
Clin. Orthop. Relat. Res.
0009-921X,
466
, pp.
2706
2710
.
30.
Chin
,
K. R.
,
Dalury
,
D. F.
,
Zurakowski
,
D.
, and
Scott
,
R. D.
, 2002, “
Intraoperative Measurements of Male and Female Distal Femurs During Primary Total Knee Arthroplasty
,”
Am. J. Knee Surg.
0899-7403,
15
, pp.
213
217
.
31.
Hitt
,
K.
,
Shurman
,
J. R.
,
Greene
,
K.
,
McCarthy
,
J.
,
Moskal
,
J.
,
Hoeman
,
T.
, and
Mont
,
M. A.
, 2003, “
Anthropometric Measurements of the Human Knee: Correlation to the Sizing of Current Knee Arthroplasty Systems
,”
J. Bone Jt. Surg., Am. Vol.
0021-9355,
85A
(
4
), pp.
115
122
.
32.
Scuderi
,
G. R.
,
Insall
,
J. N.
,
Windsor
,
R. E.
, and
Moran
,
M. C.
, 1989, “
Survivorship of Cemented Knee Replacements
,”
J. Bone Joint Surg. Br.
0301-620X,
71
, pp.
798
803
.
33.
Kotani
,
A.
,
Yonekura
,
A.
, and
Bourne
,
R. B.
, 2005, “
Factors Influencing Range of Motion After Contemporary Total Knee Arthroplasty
,”
J. Arthroplasty
0883-5403,
20
, pp.
850
856
.
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