Gender-Specific High-Flexion Knee Prosthesis in Indian Women: A Prospective Randomised Study

Abstract

Purpose. To compare outcomes in Indian women who underwent total knee arthroplasty (TKA) using the standard Legacy Posterior Stabilised (LPS) versus the gender-specific LPS high-flexion knee prosthesis. Methods. 100 women (200 knees) aged 60 to 80 years with an arc of flexion of ≥90° underwent simultaneous sequential TKA for primary osteoarthritis of both knees. They were randomised to receive the standard NexGen LPS prosthesis (n=50) or the gender-specific NexGen LPS High-Flex prosthesis (n=50). Both knees in each patient received the same prosthesis. The resected bone from the posterior femoral condyle was 2 mm greater when the gender-specific prosthesis was used. Patients were followed up at 3, 6, 12, and 24 months. Range of motion, Knee Society score, and Hospital for Special Surgery score were evaluated pre- and post-operatively by a single assessor. Results. The mean follow-up duration was 2.1 (range, 1.6–2.5) years. Respectively for the standard and gender-specific groups, the mean range of motion was 111° and 112° preoperatively and 120° and 123° at the latest follow-up. The gender-specific group gained approximately 3° more in range of motion (p=0.007). The Knee Society score and the Hospital for Special Surgery score between groups were not significantly different pre- and post-operatively. Conclusion. The perceived advantage of a gender-specific prosthesis over a standard prosthesis did not translate into better clinical and functional outcome scores.