Gender Differences in Patellofemoral Joint Biomechanics
To the Editor:
It was with keen interest that I read the paper “Gender differences in patellofemoral biomechanics” by Csintalan et al.1 They found higher patellofemoral contact pressures in females compared with males, and greater contact area in males compared with females. Thus, pressure (=force/area) should be greater in females, assuming that joint forces of males and females are equal. They thought that greater contact area in males could not be related purely to size differences between males and females. The basis of this conclusion was that surface areas were 33% greater in males, a figure that exceeded the average increase in size (femoral biepicondylar width) of 10%. However, to render the width and area data comparable it is necessary to transform either width (mm) or area (mm2) by taking the square or square root of these measures, respectively. Thus, mean biepicondylar widths of 9.2 cm (males) and 8.1 cm (females), in terms comparable with area, reflected a 29% ((9.2/8.1)2 × 100 = 129%) increase in size. Therefore, there was little evidence that differences in contact areas reflected anything more than overall body size differences between males and females; the finding of greater female contact stresses was attributable to the questionable assumption that smaller individuals experience the same forces as larger individuals.
Christopher D. S. Jones, PhD
Adelaide, South Australia
REFERENCE
1. Csintalan RP, Schultz MM, Woo J, McMahon PJ, Lee TQ. Gender differences in patellofemoral joint biomechanics. Clin Orthop. 2002; 402:260–269.
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