High Femoral Anteversion Is Related to Femoral Trochlea Dysplasia

Liebensteiner, Michael; Ressler, Julia Maria; Seitlinger, Gerd; Djurdjevic, Tanja; Attal, R.; Ferlic, Peter

doi:10.1016/j.arthro.2016.03.023

Cited by 65 publications

(59 citation statements)

References 24 publications

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“…For example, it was shown that increased femoral torsion is associated with a flatter, more dysplastic trochlea, which can lead to patellofemoral instability. This was particularly true for torsion located on the distal femur [3].…”

Section: Discussionmentioning

confidence: 98%

“…The third axis was defined by a tangent to the dorsal part of the distal femur in the transverse slice just above the point of attachment of the gastrocnemius heads and the fourth axis by a tangent to the posterior condyles ( Fig. 1) [3,10].…”

Section: Parameters Of Femoral Torsionmentioning

confidence: 99%

“…Torsional deformities of the femur have an impact on the biomechanics and forces acting in the hip and knee and play a significant role in the development of disorders of these joints [1][2][3]. Deformities of the femur have been treated with de-rotational osteotomies for many years [4,5].…”

Section: Introductionmentioning

confidence: 99%

“…Consequently, the aim of this study was to adapt and validate a recently published measurement protocol for the determination of femoral torsion, which should make it possible to detect the part of the femur in which the torsional deformity is localized, instead of measuring femoral torsion solely between the proximal and distal ends of the femur [3,10]. It was hypothesized that this multi-level measurement protocol is a reliable tool for evaluation of the magnitude of torsion of the respective femoral segments and for differentiation of their contribution to overall femoral torsion.…”

Section: Introductionmentioning

confidence: 99%

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Segmental torsion assessment is a reliable method for in-depth analysis of femoral alignment in Computer Tomography

Ferlic

Runer

Seeber

et al. 2017

International Orthopaedics (SICOT)

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Purpose De-rotational osteotomies are indicated in patients with pathologic femoral torsion. However, there is disagreement whether an osteotomy should be performed proximally or distally. Conventionally only the total torsion is measured, which does not allow differentiation between a torsional deformity located in the proximal or distal metaphysis or the diaphysis. The aim of this study is to validate a new multilevel measurement protocol for evaluation of the magnitude of torsion of the respective femoral segments in CT. Patients and methods The torsional profile of 30 femora was evaluated in CT scans. For separate measurements of the torsion of the metaphysis and the diaphysis, four axes where determined: one through the femoral neck, a second determined by the midpoint of the femoral shaft and the lesser trochanter, a third determined by a tangent dorsal to the popliteal surface, and a fourth axis posterior to the condyles. The total femoral torsion was measured between the first and the fourth axis, proximal torsion between the first and the second, mid torsion between the second and the third, and distal torsion between the third and the fourth axis. Four investigators performed all measurements independently and intraclass correlation coefficients (ICC) were calculated to evaluate intra-and inter-rater reliability. Results Average total femoral torsion was 22.6 ± 8.7°, proximal torsion 47.7 ± 10.6°, mid torsion −33.4 ± 9.9°, and distal torsion 8.3 ± 3.2°. Intra-rater ICC ranged between 0.504 and 0.957 and inter-rater ICC between 0.643 and 0.992. The majority of the ICC were graded as Balmost perfect^and some as Bsubstantial^agreement. Conclusion Evaluation of the segmental torsion of the femur allows in-depth analysis of femoral alignment. High reliability was shown for this measuring method in computed tomography, which can be deployed when studying interdependencies between joint pathologies and torsional deformities or when planning the site for an osteotomy. Level of evidence Level III.

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Section: Discussionmentioning

confidence: 98%

Section: Parameters Of Femoral Torsionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Segmental torsion assessment is a reliable method for in-depth analysis of femoral alignment in Computer Tomography

Ferlic

Runer

Seeber

et al. 2017

International Orthopaedics (SICOT)

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“…The 3D computed tomography (CT) measures for FAA are reliable within individual rater and between different raters. The 3D CT measueres of FAA can be a useful method for accurate diagnosis and follow-up of femoral anteversion (34,35). Besides alignment guides, rulers, and other tools, intraoperative fluoroscopy and computer-guided navigation allow the surgeon to intraoperatively analyze leg length and offset changes in relation to the FAA (36)(37)(38)(39)(40).…”

Section: Discussionmentioning

confidence: 99%

Clinical importance and sex differences of the femoral anteversion angle

Kapur

Dračić

Gračić

2019

JHSCI

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Introduction: The Femoral angle of anteversion (FAA) is responsible for the medial and anterior direction of the femoral neck and therefore the femoral head towards the acetabulum. The aim of this study was to determine the difference in FAA between male and female samples, the correlation between the FAA and biomechanically relevant parameters and to provide a review of relevant clinical features related to FAA. Methods: We included 100 human dry femora and analyzed FAA, Angle of Inclination (AI), Femoral Head Diameter (FHD), Femoral Biomechanical Length (FBL) and Linear Condylar Parameters (Epicondylar Breadth Width (EBW), Lateral Condyle Depth and Medial Condyle Depth). The measurements were made using a goniometer, sliding calipers and pieces of colored string. Results: Mean FAA values were 9.84±7.97° and 8.72±8.23° for the male and female samples, respectively (p<0.05). FAA and AI in both male and female correlated negatively (-0.076), while there was a positive correlation between FAA and FHD (0.069), FAA and FBL (0.072), FAA and EBW (0.029), while the correlation was negative between FAA and LCD (-0.072), FAA and MCD (-0.063). Conclusion: The difference in FAA between male and female femora was found to be significant. This finding may help better understanding such as hip impingement, total hip arthroplasty failure, and design of femoral endoprosthesis parts.

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Effects of hindlimb suspension on development of proximal and distal femur morphological abnormalities in growing rats

Ozawa

Kaneguchi

Ezumi

et al. 2022

Journal Orthopaedic Research

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Although morphological abnormalities of the femur are known predisposing factors for numerous musculoskeletal disorders, the etiology of these abnormalities is poorly understood. This study aimed to investigate whether femoral morphogenesis is affected by hindlimb suspension (HS) in growing rats. We used 41 four‐week‐old female rats in this study. In the HS groups, rats were suspended from their tails for 2, 4, and 8 weeks. Age‐matched animals were used as controls. We examined morphological indices of the femur using three‐dimensional reconstructed images from X‐ray computed tomography. The femoral neck anteversion angle (AVA) was higher with growth in the experimental groups and did not differ in control groups. The AVAs in the HS groups were larger than controls at any time point. In the control groups, the trochlear angle (TA) was higher, rotating inward with growth, but did not differ in the HS groups. The TAs in the HS groups were smaller and rotated more outward compared with the control groups at any time point. The height ratios of the medial and lateral condyles (MC/LC), an asymmetry index, were larger in the HS groups compared to controls at any time point. There were strong relationships between proximal (AVA) and distal morphologies, such as the TA (Spearman's coefficient [rs] = −0.80, p < 0.001) and MC/LC (rs = 0.79, p < 0.001). Our data suggest that sufficient physical activity in early life may protect against morphological femur abnormalities associated with hip and knee joint diseases.

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High Femoral Anteversion Is Related to Femoral Trochlea Dysplasia

Cited by 65 publications

References 24 publications

Segmental torsion assessment is a reliable method for in-depth analysis of femoral alignment in Computer Tomography

Segmental torsion assessment is a reliable method for in-depth analysis of femoral alignment in Computer Tomography

Clinical importance and sex differences of the femoral anteversion angle

Effects of hindlimb suspension on development of proximal and distal femur morphological abnormalities in growing rats

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