EC Orthopaedics

Knee osteoarthritis (OA) remains a premier driver of musculoskeletal disability, chronic pain, and health economic burdens within the Indian subcontinent [1]. While the progressive degradation of articular cartilage is universally tied to chronological aging, its structural integrity is profoundly dictated by biological sex and unique population-specific morphometry. This retrospective cross-sectional analysis synthesizes large-scale epidemiological insights from the longitudinal ageing study in India (LASI) with localized primary morphometric data from a clinical cohort (N = 111) evaluating structural vulnerabilities. Our findings demonstrate a stark, undeniable sexual dimorphism across all primary femoral and tibial dimensions. Notably, female subjects exhibited significantly smaller absolute joint dimensions-typified by a mean femoral mediolateral (FML) width of 71.44 +/- 7.1 mm compared to 79.12 +/- 7.4 mm in male counterparts-translating into an estimated 1.5- to 1.6-fold higher likelihood of requiring further surgical intervention. Chronologically, an epidemiological “crossover” manifests during the fifth decade of life, where female prevalence and symptom severity steeply surpass male baselines, directly mirroring post-menopausal endocrine transitions. Furthermore, traditional socio-behavioral and ergonomic variables unique to Indian domestic and occupational life heavily exacerbate these underlying anatomical risks. This paper underscores the urgent requirement for population-specific, sex-segregated orthopedic design standards, highlighting why relying on Western-centric, male-skewed commercial implant configurations introduces a high risk of component mismatch and subsequent long-term arthroplasty failure.

Keywords: Sexual Dimorphism; Knee Morphometry; Osteoarthritis; Femoral Mediolateral (FML)

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