Abstract
The purpose of this study was to assess potential gender differences in size of the
lateral and medial trochlea of the male and female knee as well as the variation within
gender of potential osteochondral autograft transfer (OAT) donor site area. Two hundred
and twelve skeletally mature patients, 106 males and 106 females, who underwent a
3T magnetic resonance imaging of the knee for a variety of indications were utilized
for analysis. Exclusion criteria included degenerative arthritis, trochlear dysplasia,
and poor image quality. Medial and lateral femoral trochlear cartilage width was obtained
using a linear radiologic measurement tool. Widths were measured from a reproducible
anatomic location representing the maximal trochlear dimension in a region where donor
plugs are commonly harvested. Trochlear width was also plotted as a function of patient
height. Statistical analysis was performed using a two-sample t-test. The mean and standard deviation of the lateral trochlear cartilage width (mm)
for males and females were 23.38 +/− 2.14 and 20.44 +/− 2.16, respectively (p < 0.00001). The mean and standard deviation of the medial trochlear cartilage width
(mm) for males and females were 14.16 +/− 2.17 and 11.78 +/− 2.03, respectively (p < 0.00001). The overall range in trochlear width for both the lateral and medial
sides was 22.22 and 19.73 mm for males and females, respectively. A graft measuring
10 mm could represent as little as 34% of the lateral trochlea in males versus as
much as 65% in females. Our results indicate that donor OAT plug diameter relative
to available trochlear cartilage width will vary significantly both between genders
and individual patients. Trochlear width variability and its potential implications
on donor site morbidity may be an important consideration when contemplating osteochondral
plug harvest for OAT or other indications. The level of evidence is IV.
Keywords
knee - cartilage - OAT - donor site morbidity
