Common Misconceptions of Normal Hip Joint Relations on Pelvic Radiographs

Krishnan, Shibu P.; Carrington, R; Mohiyaddin, Syed; Garlick, Nicholas

doi:10.1016/j.arth.2005.10.021

Cited by 64 publications

(40 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Approximately 60% of cases showed that the femoral head offset was not restored when using 135° CDA and 32% of cases had the same result when using 131° CDA implants [33]. However, several studies indicated that there was no correlation between the femoral head offset and femoral anteversion because periosteal features were independently compared with the endosteal canal [37, 38]. After a femora neck is resected during surgery, it is crucial that the center of the femoral head is in the same position it was prior to the surgery to restore the offset and femoral length [37].…”

Section: Discussionmentioning

confidence: 99%

Morphological Study of the Newly Designed Cementless Femoral Stem

Baharuddin

Salleh

Zulkifly

et al. 2014

BioMed Research International

View full text Add to dashboard Cite

A morphology study was essential to the development of the cementless femoral stem because accurate dimensions for both the periosteal and endosteal canal ensure primary fixation stability for the stem, bone interface, and prevent stress shielding at the calcar region. This paper focused on a three-dimensional femoral model for Asian patients that applied preoperative planning and femoral stem design. We measured various femoral parameters such as the femoral head offset, collodiaphyseal angle, bowing angle, anteversion, and medullary canal diameters from the osteotomy level to 150 mm below the osteotomy level to determine the position of the isthmus. Other indices and ratios for the endosteal canal, metaphyseal, and flares were computed and examined. The results showed that Asian femurs are smaller than Western femurs, except in the metaphyseal region. The canal flare index (CFI) was poorly correlated (r < 0.50) to the metaphyseal canal flare index (MCFI), but correlated well (r = 0.66) with the corticomedullary index (CMI). The diversity of the femoral size, particularly in the metaphyseal region, allows for proper femoral stem design for Asian patients, improves osseointegration, and prolongs the life of the implant.

show abstract

Section: Discussionmentioning

confidence: 99%

Morphological Study of the Newly Designed Cementless Femoral Stem

Baharuddin

Salleh

Zulkifly

et al. 2014

BioMed Research International

View full text Add to dashboard Cite

show abstract

“…Only the radiographs complying with the following criteria were used [25]: (1) no significant deformity of the femoral head; (2) no developmental dysplasia; (3) no obvious disorder of the lower limb that could be another cause of LLD; (4) no previous arthroplasty of the hip, knee, or ankle; (5) no clinical evidence for flexion contractures of the hip or knee; (6) similar size of the lesser trochanter and the degree of overlap of the medial cortex of the greater trochanter on both sides to exclude asymmetric rotation of both legs [10]; (7) distance between the symphysis and the sacrococcygeal joint of approximately 30 mm (range, 10-40 mm) in men compared with 50 mm (range, 40-60 mm) in women to exclude abnormal pelvic tilt in the sagittal plane [45,48]; and (8) coccyx centered on the pubic symphysis to exclude rotation of the pelvis in the transverse plane [48].…”

Section: Methodsmentioning

confidence: 99%

Preoperative Radiographic Assessment of Limb-length Discrepancy in Total Hip Arthroplasty

Meermans

Malik

Witt

et al. 2011

Clinical Orthopaedics &Amp; Related Research

149

View full text Add to dashboard Cite

Background Pelvic radiographs are helpful in assessing limb-length discrepancy (LLD) before and after THA but are subject to variation. Different methods are used to determine LLDs. As a pelvic reference, both ischial tuberosities and the teardrops are used, and as a femoral reference, the lesser trochanter and center of the femoral head are used. Questions/purposes We validated the different methods for preoperative radiographic measurement of LLDs and evaluated their reliability. Patients and Methods LLDs were measured on full-leg radiographs for 52 patients (29 men, 23 women) with osteoarthritis (OA) of the hip and compared with different methods for measuring LLDs on AP radiographs of the pelvis. Results The true LLD varied from À8.0 to 9.1 mm. When the biischial line was used as a pelvic reference, the LLD measured on AP pelvis radiographs was different from the true LLD. No difference was found when the interteardrop line was used as a pelvic reference. There was substantial interobserver agreement when the lesser trochanter was used as a femoral reference (kappa = 0.66-0.70) and excellent interobserver and intraobserver agreement for all other measurements (kappa = 0.84-0.93). Conclusions Our data show use of the biischial line as a pelvic reference should be discouraged and the interteardrop line is a better alternative. The center of the femoral head is a more reliable femoral landmark compared with the lesser trochanter. Level of Evidence Level I, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.

show abstract

“…We were aware that hip offset is not always symmetrical: one hip may have a greater offset than that of the contralateral hip in the same patient. The mean difference between normal hips in one study was 2.54 ± 2.31 mm [11]. In hips with asymmetrical offset the normal cannot be compared to the arthritic without accounting for the magnitude of the asymmetry (Fig.…”

Section: Methodsmentioning

confidence: 99%