Upper Femur Anatomy Depends on Age and Gender: A Three-Dimensional Computed Tomography Comparative Bone Morphometric Analysis of 628 Healthy Patients’ Hips

Carmona, Max; Tzioupis, Chris; LiArno, Sally; Faizan, Ahmad; Argenson, Jean-Noël; Ollivier, Matthieu

doi:10.1016/j.arth.2019.05.036

Cited by 20 publications

(23 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A significant asymmetry was found between the left side and the right side for both femoral and tibial torsion. This result is in line with two 3D studies on the proximal femur [3,10]. Other studies have found differences side-to-side difference between TT values based using 2D measurement [30,34].…”

Section: Discussionsupporting

confidence: 91%

Healthy middle-aged Asian and Caucasian populations present with large intra- and inter-individual variations of lower limb torsion

Mathon

Micicoi

Seil

et al. 2020

Knee Surg Sports Traumatol Arthrosc

Self Cite

View full text Add to dashboard Cite

Purpose There is a lack of standardization in the measurement of lower limb torsional alignment. Normal values published in the literature are inconsistent. A 3D-CT-scan-based method was used in a healthy population to define the femoral neck version (FNV) and the tibial torsion (TT) and their relationship with demographic parameters. The study objectives were (1) to define normal values of lower limb torsional alignment, (2) to estimate inter-and intra-individual variations of torsional deformity of healthy individuals' lower limbs. The hypothesis was that FNV and TT values would be influenced by patient characteristics such as gender, age, and ethnicity, and would have low side-to-side asymmetry. Methods Torsional landmarks of the lower limbs from 191 healthy subjects were automatically calculated with a 3D CTscan-based program. The FNV was defined by the angle between the femoral neck axis and the femoral posterior condylar line. The TT angle was considered between the tibial plateau axis and the axis of the ankle. For the former, two alternatives were considered: the line connecting the more medial and lateral point of the medial and lateral plateau, respectively (method 1; TT1), or the line connecting the two more posterior points of the medial et lateral plateau (method 2; TT2). The ankle axis was defined as the line connecting the medial and lateral malleoli. These reference lines were automatically calculated. Age, gender, ethnic group, and BMI were recorded for every subject. A p value < 0.05 was considered as statistically significant. Results Overall, the mean FNV was 15.3 ± 9.5° and the mean TT was 31.6 ± 6.3°. Female hips were more anteverted than male hips. Caucasians had less anteverted hips than Asians, but more externally rotated tibias. Age and BMI were not correlated with any anatomical parameter. A substantial side-to-side asymmetry was found for FNV [absolute difference (AD) = 6.3°; percentage of asymmetry (%As) = 47%], TT1 (AD = 3°; %As = 12%), and TT2 (AD = 4.9°; %As = 9%) (p = 0.008). ConclusionThe findings showed that lower limb torsional parameters were highly variable from patient to patient and from one leg to the other for the same patient. The understanding of normal values concerning femoral version and external tibial torsion in the present healthy population will help surgeons to define pathological values of FNV and TT, as well as corrections to perform in case of torsional deformities. Level of evidence Level III.

show abstract

Section: Discussionsupporting

confidence: 91%

Healthy middle-aged Asian and Caucasian populations present with large intra- and inter-individual variations of lower limb torsion

Mathon

Micicoi

Seil

et al. 2020

Knee Surg Sports Traumatol Arthrosc

Self Cite

View full text Add to dashboard Cite

show abstract

“…Furthermore, the purpose of this study is to guide femoral preparation for arthroplasty so these measurements would necessarily be made on arthritic hips in clinic practice. Prior morphologic studies have demonstrated increased femoral neck/shaft varus and offset and decreased mineralization of the proximal femur, but no changes in trochanteric overhang have been reported [21]. Nevertheless, we acknowledge that trochanteric osteophytes, enthesopathy, or peritrochanteric heterotopic bone formation may skew our measurements.…”

Section: Discussionmentioning

confidence: 76%

Morphology of the Greater Trochanter: An Assessment of Anatomic Variation and Canal Overhang

et al. 2020

View full text Add to dashboard Cite

Background: Varus malposition is a risk of early failure in total hip arthroplasty. The degree to which the tip of the greater trochanter (GT) overhangs the canal can increase this risk. Although we know proximal femoral anatomy is variable, no study has addressed variations in medial overhang of the GT on plain radiographs. Methods: All low anteroposterior pelvis radiographs more than 1 year were reviewed 3 times by 2 orthopaedic surgeons and one radiologist. The canal width (CW) was measured 10 cm below the lesser trochanter. Canal overhang (CO) was defined by the distance between the lateral medullary canal and a parallel line beginning at the most medial aspect of the GT. The overhang index (OI) is defined as the percentage of the canal overhung by the GT. Results: The mean CW was 13.5 mm, mean CO 16.4 mm, and mean OI 1.22. Hips were then classified as the following: (A) OI < 0.5 (n ¼ 8), (B) OI 0.5-1.0 (n ¼ 78), (C) OI 1.0-1.5 (n ¼ 191), and (D) OI > 1.5 (n ¼ 68). Intraobserver reliability was excellent for all measures: 0.89 (confidence interval: 0.87-0.91) for CW, 0.96 (0.95-0.97) for CO, and 0.97 (0.97-0.98) for OI. Interobserver reliability was good for CW 0.75 (0.70-0.79) and excellent for CO 0.90 (0.88-0.92) and OI 0.95 (0.94-0.96). Conclusions: Variations in the morphology of the proximal femur can predispose to varus component malposition. The degree to which the GT overhangs the canal can be quantified and classified based on plain films. This can aid in preoperative planning and help guide intraoperative proximal femoral preparation.

show abstract

“…4.2 Aging of the Deceased -The use of three-dimensional geometric morphometric analysis of sections of large bones, such as the femur, the pelvis or the ribs, using PMCT, allows the identification of age-related features. Said features could be used to establish the age of the deceased at the time of their death [55][56][57][58]. To do this, a series of relevant geometrical landmarks are examined, from morphological features, such as the bicondylar breadth (BCB) in the case of the femur [55] or the inter-pubic distance in the case of the pelvis [57]; to age-related physiological processes like the ossification around sternum and ribs ends [58].…”

Section: Applications Of Virtual Autopsymentioning

confidence: 99%

A review on the evolution and characteristics of post-mortem imaging techniques

Morillas

Nurgaliyeva²,

Gooch

et al. 2020

Forensic Imaging

View full text Add to dashboard Cite

Upper Femur Anatomy Depends on Age and Gender: A Three-Dimensional Computed Tomography Comparative Bone Morphometric Analysis of 628 Healthy Patients’ Hips

Cited by 20 publications

References 49 publications

Healthy middle-aged Asian and Caucasian populations present with large intra- and inter-individual variations of lower limb torsion

Healthy middle-aged Asian and Caucasian populations present with large intra- and inter-individual variations of lower limb torsion

Morphology of the Greater Trochanter: An Assessment of Anatomic Variation and Canal Overhang

A review on the evolution and characteristics of post-mortem imaging techniques

Contact Info

Product

Resources

About