Traditional knee implants have been designed "down the middle,"based on the combined average size and shape of male and female knee anatomy.Sex-based research in the field of orthopaedics has led to new understanding of the anatomic differences between the sexes and the associated implications for women undergoing total knee arthroplasty. Through the use of a comprehensive bone morphology atlas that utilizes novel three-dimensional computed tomography analysis technology, significant anatomic differences have been documented in the shape and size of female knees compared with male knees. This research identifies three notable anatomic differences in the female population: a less prominent anterior condyle, an increased Q angle, and a reduced medial-lateral:anterior-posterior aspect ratio.