The Validity and Reliability of Preoperative Radiographic Canal Diameter Measurements of the Femur

Walsh, Kenneth P.; Fowler, John R.; Chen, Oliver; Gaughan, John; Ali, Sayed; Rehman, Mahin; Rehman, Saqib

doi:10.1007/s11420-013-9334-z

Cited by 12 publications

(7 citation statements)

References 10 publications

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“…However, the incidence of Crowe type IV DDH is relatively low, and it is difficult to obtain a larger data series from a single institution. Second, the method of assessing the radiographic diameter of the femoral canal was imprecise as the femoral canal is not precisely round; however, other studies [43][44][45] have used similar approximate methods to assess the diameter of the femoral canal, and, therefore, we believe our final assessments of the contact areas and coincidence rates are valid.…”

Section: N a N A N A N A N A N A N A N A N A N A N A N A N A N Amentioning

confidence: 98%

Optimal location of subtrochanteric osteotomy in total hip arthroplasty for crowe type IV developmental dysplasia of hip

Huang

Liu

et al. 2020

BMC Musculoskelet Disord

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Background: When reconstructing a hip with developmental dysplasia and high dislocation, sub-trochanteric shortening osteotomy is typically needed for placing the acetabular component in the appropriate anatomical position. However, the procedure can result in complications such as non-union of the osteotomy. We evaluated the contact area and the coincidence rate between the proximal and distal fragments at different femoral osteotomy levels and lengths. We then determined the optimal location of subtrochanteric femoral shortening transverse osteotomy in patients with unilateral Crowe type IV developmental dysplasia of the hip (DDH). The consistency between the proximal and distal segments was assessed as a possible predictive indicator of the union at the osteotomy site. Methods: We retrospectively reviewed 57 patients with unilateral Crowe type IV DDH who underwent X-ray imaging of both hip joints. We labelled the inner and outer diameters of the circular ring as N (mm) and M (mm), respectively. We defined the overlapped area between the proximal and distal ring as contact area S (mm 2), and the ratio of contact area to distal ring area as coincidence rate R. Results: N varied from 9.8-15.2 mm and M varied from 20.7-24 mm, both demonstrated a decreasing trend in the proximal to distal direction. At osteotomy lengths ranging from 0.5-2 cm, there were no differences in S between the different levels of osteotomy in each group. At osteotomy lengths ≤2.5 cm, a significant higher coincidence rate was noted from 2 cm below the lesser trochanter to other positions below the level. At osteotomy lengths from 3 to 5.5 cm, a significantly higher coincidence rate was observed from the level of 1.5 cm below the lesser trochanter to other positions below the level. Conclusions: Our findings suggest that femoral shortening transverse osteotomy at the optimal subtrochanteric level can predictably increase the contact area and coincidence rate, which may contribute to the union at the osteotomy site. Considering the stability of the prostheses, it appears appropriate that osteotomy location should be shifted slightly distally. Trial registration: Retrospectively registered.

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Section: N a N A N A N A N A N A N A N A N A N A N A N A N A N Amentioning

confidence: 98%

Optimal location of subtrochanteric osteotomy in total hip arthroplasty for crowe type IV developmental dysplasia of hip

Huang

Liu

et al. 2020

BMC Musculoskelet Disord

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“…The intramedullary femoral guide rod can be jammed into the femoral isthmus during the process of total hip arthroplasty, and this jamming can be avoided with precise preoperative measurements regarding the diameter and location of the canal isthmus [ 5 , 6 ]. Traditional measurement methods of femoral morphology are primarily based on two-dimensional (2D) images, such as anterior-posterior (AP) X-ray films [ 2 , 7 – 10 ]. Compared to 2D measurement methods, Walsh et al reported that the diameter of the canal was measured more accurately using coronal computed tomography (CT) images [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Traditional measurement methods of femoral morphology are primarily based on two-dimensional (2D) images, such as anterior-posterior (AP) X-ray films [ 2 , 7 – 10 ]. Compared to 2D measurement methods, Walsh et al reported that the diameter of the canal was measured more accurately using coronal computed tomography (CT) images [ 10 ]. However, neither 3D geometry projected onto 2D planes nor selected CT images could accurately reflect the detailed osseous morphology of the femoral canal in 3D space; thus, the current methods are unreliable.…”

Section: Introductionmentioning

confidence: 99%

Three-Dimensional Analysis of the Characteristics of the Femoral Canal Isthmus: An Anatomical Study

Zhao

et al. 2015

BioMed Research International

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Purpose. To establish a new approach for measuring and locating the femoral intramedullary canal isthmus in 3-dimensional (3D) space. Methods. Based on the computed tomography data from 204 Chinese patients, 3D models of the whole femur and the corresponding femoral isthmus tube were reconstructed using Mimics software (Materialise, Haasrode, Belgium). The anatomical parameters of the femur and the isthmus, including the femur length and radius, and the isthmus diameter and height, were measured accordingly. Results. The mean ratio of the isthmus height versus the femoral height was 55 ± 4.8%. The mean diameter of the isthmus was 10.49 ± 1.52 mm. The femoral length, the isthmus diameter, and the isthmus tube length were significantly larger in the male group. Significant correlations were observed between the femoral length and the isthmus diameter (r = 0.24, p < 0.01) and between the femoral length and the isthmus height (r = 0.6, p < 0.01). Stepwise linear regression analyses demonstrated that the femoral length and radius were the most important factors influencing the location and dimension of the femoral canal isthmus. Conclusion. The current study developed a new approach for measuring the femoral canal and for optimization of customer-specific femoral implants.

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“…However, the incidence of Crowe type IV DDH is relatively low, and it is difficult to obtain a larger data series from a single institution. Second, the method of assessing the radiographic diameter of the femoral canal was imprecise as the femoral canal is not precisely round; however, other studies [43][44][45] Flowchart depicting the selection of hips to be evaluated.…”

Section: Discussionmentioning

confidence: 99%

Optimal Location of Subtrochanteric Osteotomy in Total Hip Arthroplasty for Crowe Type IV Developmental Dysplasia of Hip

Huang

Liu

et al. 2020

Preprint

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Background When reconstructing a hip with developmental dysplasia and high dislocation, sub-trochanteric shortening osteotomy is typically needed for placing the acetabular component in the appropriate anatomical position. However, the procedure can result in complications such as non-union of the osteotomy. We evaluated the contact area and the coincidence rate between the proximal and distal fragments at different femoral osteotomy levels and lengths. We then determined the optimal location of subtrochanteric femoral shortening transverse osteotomy in patients with unilateral Crowe type IV developmental dysplasia of the hip (DDH). The consistency between the proximal and distal segments was assessed as a possible predictive indicator of the union at the osteotomy site. Methods We retrospectively reviewed 57 patients with unilateral Crowe type IV DDH who underwent X-ray imaging of both hip joints. We labelled the inner and outer diameters of the circular ring as N (mm) and M (mm), respectively. We defined the overlapped area between the proximal and distal ring as contact area S (mm 2 ), and the ratio of contact area to distal ring area as coincidence rate R. Results N varied from 9.8–15.2 mm and M varied from 20.7–24 mm, both demonstrated a decreasing trend in the proximal to distal direction. At osteotomy lengths ranging from 0.5–2 cm, there were no differences in S between the different levels of osteotomy in each group. At osteotomy lengths ≤ 2.5 cm, a significant higher coincidence rate was noted from 2 cm below the lesser trochanter to other positions below the level. At osteotomy lengths from 3–5.5 cm, a significantly higher coincidence rate was observed from the level of 1.5 cm below the lesser trochanter to other positions below the level. Conclusions Our findings suggest that femoral shortening transverse osteotomy at the optimal subtrochanteric level can predictably increase the contact area and coincidence rate, which may contribute to the union at the osteotomy site. Considering the stability of the prostheses, it appears appropriate that osteotomy location should be shifted slightly distally.

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The Validity and Reliability of Preoperative Radiographic Canal Diameter Measurements of the Femur

Cited by 12 publications

References 10 publications

Optimal location of subtrochanteric osteotomy in total hip arthroplasty for crowe type IV developmental dysplasia of hip

Optimal location of subtrochanteric osteotomy in total hip arthroplasty for crowe type IV developmental dysplasia of hip

Three-Dimensional Analysis of the Characteristics of the Femoral Canal Isthmus: An Anatomical Study

Optimal Location of Subtrochanteric Osteotomy in Total Hip Arthroplasty for Crowe Type IV Developmental Dysplasia of Hip

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