The Modified Femoral Neck-Shaft Angle: Age- and Sex-Dependent Reference Values and Reliability Analysis

Boese, Christoph Kolja; Frink, Michael; Jostmeier, Janine; Haneder, Stefan; Dargel, Jens; Eysel, Peer; Lechler, Philipp

doi:10.1155/2016/8645027

Cited by 20 publications

(20 citation statements)

References 19 publications

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“…We agree with Müller et al 17 , about their definition of functional anteversion as a sum of rotatory and tilted anteversion. In accordance to our results, a false entry point results to deviations of the final stem anteversion, a situation that has been proved to lead to increased rates of impingement and/ or dislocation 5,15 .…”

Section: Discussionsupporting

confidence: 91%

“…Finally, after stem implantation and in order to define the ideal stem axis (p axis), two circles were drawn, as described by Boese et al 15 . The proximal circle with the centre on the z axis above the distal end of lesser trochanter and the distal circle with the centre on the midpoint of the femur, 150 mm distally to the first one, using a stem of 150 mm long and depth of 10 mm at the most proximal region.…”

Section: Cadaveric Measurementsmentioning

confidence: 99%

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Femoral stem sagittal balance - Do we need a new entry point?

Rozis¹,

Bakalakos²,

Polyzois³

et al. 2018

JRPMS

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Objectives: Femoral stem positioning is of great importance in hip arthroplasty. Straight stem sagittal balance gains recently more attention in the literature. Methods: We performed a both clinical and cadaveric study in order to identify a possible ideal stem entry point at the level of the proximal femur, that ensures an optimal sagittal stem centering. We compared the sagittal tilt of 52 patients with femoral stem implantation in post-operative x-rays, dividing them in two groups depending on posterior neck cortex perforation. Subsequently, femoral neck osteotomy was performed in 40 cadaveric femurs. After placing an average straight stem, measurements of stem axis and femoral neck were made, in order to identify a possible area that could be used as a landmark, through which an optimal sagittal centering could be achieved. Results: Based on our results, stem sagittal tilt differed significantly when posterior neck was spared. In cadaveric evaluation, when posterior neck cortex was not perforated, the tip of stem was in contact with the posterior diaphysis cortex, thus malpositioned in the sagittal plane. We additionally found a statistically significant difference between neck centre and a) stem posterior boarder and b) neck posterior cortex distance. Conclusions: We conclude that placing the femoral stem just posteriorly to the posterior neck cortex, seems to be a good technique in order to achieve optimal sagittal balance of the femoral component.

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Section: Discussionsupporting

confidence: 91%

Section: Cadaveric Measurementsmentioning

confidence: 99%

Femoral stem sagittal balance - Do we need a new entry point?

Rozis¹,

Bakalakos²,

Polyzois³

et al. 2018

JRPMS

View full text Add to dashboard Cite

show abstract

“…Coxa valga has been defined as increased FNS [ 14 15 16 ]. Several studies have reported the effects of age and sex on FNS [ 9 10 11 ]. The FNS is largest during childhood and begins to decline during adolescence, slowing further during adulthood.…”

Section: Discussionmentioning

confidence: 99%

“…Our study reported a similar trend in age, which was lower according to aging (p=0.012) ( Table 4 ). Although FNS differences according to sex have not been clearly established, it was thought that there was no difference between genders [ 9 10 ]. However, one study reported that FNS was lower in females [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

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Determinants of Hip and Femoral Deformities in Children With Spastic Cerebral Palsy

Cho

Park

et al. 2018

Ann Rehabil Med

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ObjectiveTo find factors affecting hip and femoral deformities in children with spastic cerebral palsy (CP) by comparing various clinical findings with imaging studies including plain radiography and computed tomography (CT) imaging.MethodsMedical records of 709 children with spastic CP who underwent thorough baseline physical examination and functional assessment between 2 to 6 years old were retrospectively reviewed. Fifty-seven children (31 boys and 26 girls) who had both plain radiography of the hip and three-dimensional CT of the lower extremities at least 5 years after baseline examination were included in this study.ResultsThe mean age at physical examination was 3.6 years (SD=1.6; range, 2–5.2 years) and the duration of follow-up imaging after baseline examination was 68.4 months (SD=22.0; range, 60–124 months). The migration percentage correlated with motor impairment and the severity of hip adductor spasticity (R1 angle of hip abduction with knee flexion). The femoral neck and shaft angle correlated with the ambulation ability and severity of hip adductor spasticity (R1 and R2 angles of hip abduction with both knee flexion and extension).ConclusionHip subluxation and coxa valga deformity correlated with both dynamic spasticity and shortening of hip adductor muscles. However, we found no correlation between femoral deformities such as femoral anteversion, coxa valga, and hip subluxation.

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Associations between femoral 3D curvature and sagittal imbalance of spine

Lo,

Dean Fang,

Wang

et al. 2023

JOR Spine

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BackgroundThe sagittal imbalance (SI) of spine triggers compensatory mechanisms (CMs) of lower extremity (LE) to restore trunk balance. These CMs can cause long‐period stress on the femur and may possibly alter the femoral morphology. This cross‐sectional observational study aimed to answer the following questions: (a) Do SI subjects exhibit greater femoral bowing compared to subjects with sagittal balance? (b) Are there associations between femoral bowing and CMs of LE in SI subjects?MethodsSubjects who underwent biplanar full body radiographs with the EOS imaging system between January 2016 and September 2021 were recruited. Sagittal parameters included T1‐pelvic angle (TPA), pelvic incidence (PI), pelvic tilt (PT), sacral slope, lumbar lordosis (LL), PI‐LL, and PT/PI ratio. LE parameters were femoral obliquity angle (FOA), knee flexion angle (KA), and ankle dorsiflexion angle. Femoral bowing was quantified as 3D radius of femoral curvature (RFC). Associations between 3D RFC and the radiographic parameters were analyzed.ResultsA total of 105 subjects were included, classified into balance group (TPA < 14°, n = 40), SI group (TPA ≥ 14° and KA <5°, n = 30), and SI with knee flexion group (TPA ≥ 14° and KA ≥ 5°, n = 35). 3D RFC was significantly lower in SI with knee flexion group compared to the other two groups (both p < 0.001). Stepwise linear regression showed that age, SI and knee flexion, femoral length (FL), FOA, and KA were independent predictors for 3D RFC.ConclusionGreater femoral bowing is observed in subjects with SI and knee flexion compared to the balanced population. CM parameters, including KA and FOA, are associated with 3D RFC. Further longitudinal study is needed to investigate the cause‐and‐effect relationship between SI, CMs of LE, and femoral bowing.

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The Modified Femoral Neck-Shaft Angle: Age- and Sex-Dependent Reference Values and Reliability Analysis

Cited by 20 publications

References 19 publications

Femoral stem sagittal balance - Do we need a new entry point?

Femoral stem sagittal balance - Do we need a new entry point?

Determinants of Hip and Femoral Deformities in Children With Spastic Cerebral Palsy

Associations between femoral 3D curvature and sagittal imbalance of spine

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