Morphology and morphometry of the patella in a select Black South African sample

Abstract

Background

For many years, sex determination has been achieved through analysis of skeletal remains in forensic medicine. The patella can be utilized for sex determination in the absence (or damage) of the cranium, upper and lower limbs, and pelvic bones. Additionally, understanding the patella's morphology and morphometry is essential for diagnosing and treating injuries and disorders of the knee joint, as well as knee arthroplasty and patella ligament grafting (Medeiros et al., 2001). This study reviewed the morphology and morphometry of the patella in a Black African population of KwaZulu-Natal and determined if a correlation between the parameters of the patellae and sex exists.

Materials and methods

154 dry patellae belonging to a South African black population group were utilized to review their morphology and morphometry. The classifications of Wiberg (1941) and Borges et al. (2016) were adapted for the morphology. The seven morphometric measurements were adapted from Dayal and Bidmos (2005) and Borges et al. (2016). A p-value less than 0.05 was considered statistically significant.

Results

According to the Wiberg classification: Type 1 patellae were least prevalent (1.9 %), while Type 2 were most common with an incidence of 59.7 %. No statistical difference was recorded with sex (p-value = 0.517). According to Borges et al. (2016) classification: Type 1 (triangular-shaped) patellae were most prevalent in males and females (72.7 %) and Type 3 (irregular shape) patellae were least common in this study. A statistically significant difference between Borges et al. (2016) classification scheme (shape of the patella) and sexes was recorded (p-value = 0.003). A statistically significant relationship between morphometric parameters of the patella and sex was also recorded (p-value <0.001). Patella measurements were greater in males than in females.

Conclusion

In this study, the patella displayed sexually dimorphic morphological and morphometric characteristics, which indicated that the patella may be used for sex determination in forensic cases with the KwaZulu-Natal population of South Africa, in addition to clinical applications such as knee arthroplasty, patellar ligament grafting, prosthesis synthesis, and patellar implants.