The Association Between Femoral Neck-Shaft Angle and Aging and Its Influence on the Performance of Functional Activity: A Cross-Sectional Investigation

The purposes of this study were first to examine the association between aging and both the magnitude and asymmetry in the femoral neck-shaft angle (NSA). The second purpose was to determine the effects of both the magnitude and NSA asymmetry on the performance of functional activities in healthy individuals. Fifty-one subjects participated in this study. The femoral NSA was measured on computed tomography scout images. The participants performed four performance tests. Four hierarchical regression models were constructed to explore the effect of each predictor on the outcomes. Aging was associated with NSA asymmetry, but not with the degree of NSA. Age contributed significantly to the variability of all functional performance tests except the 10-m walking speed. The degree of the NSA did not contribute to the prediction of the functional performance tests. However, asymmetry in the NSA added significantly to the prediction of all functional performance tests except the 10-m walking speed.

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Sexual Variations of Femoral Neck-Shaft Angle in the Population of Odisha

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/293 ◽

2021 ◽

Vol 10 (19) ◽

pp. 1387-1390

Author(s):

Rajeev Kumar Kanchan ◽

Sonali Subhadarsini ◽

Dharma Niranjan Mishra ◽

Chinmayi Mohapatra

Keyword(s):

Femoral Neck ◽

Ventral Surface ◽

Cross Sectional Study ◽

Cross Sectional ◽

Legal Cases ◽

Male And Female ◽

Neck Shaft Angle ◽

Femur Neck ◽

Shaft Angle ◽

The Right

BACKGROUND The peculiar waddling gait of a female attracts most of the anatomists to measure and compare the neck-shaft angle (NSA) of the femora. The femoral neck shaft angle is greater in women due to greater pelvic breadth and shorter femur. Neck-shaft angle was measured by the angle that the neck makes with the shaft of the femur and it is measured on the ventral surface of femur taking the long axis of femoral neck with the long axis of the proximal end of the femur. It gives information about the race it belongs to and normally measures 120° to 140°. The intention of this study was to establish the femoral neck shaft angle variations in adult male and female for medico-legal and anthropometric studies. METHODS This cross-sectional study was conducted on 84 adult human femora of unknown sex in the anatomy department, Sriram Chandra Bhanja (SCB) Medical College, Cuttack, Odisha, from May 2018 to April 2019. We included all the femora which were free of damage or deformity and fully ossified indicating adult bone. Femora with any pathological changes i.e., cortical bone deterioration, extreme osteophyte activity, osteoarthritis and fracture etc. were excluded from the study. The NSA was measured by protractor and goniometer. RESULTS In the present study the NSA range for the right femur of male was 108° - 135° and for the right femur of females 117° - 135°. The left male femur was 118° - 135° and the left female femur was 120° - 135°. The mean neck shaft angle of male femora was 125.9° and the female femora was 125.7°. These measurements show that the values were more in males than the females. The value of the present study was statistically significant between male and female i.e., P < 0.0001. CONCLUSIONS These measurements are important in the medico-legal cases, reconstructive orthopaedic surgeries, hip replacement surgeries and also while constructing suitable prosthesis. This will also be helpful in the detection of sex by anatomists and forensic experts. KEY WORDS Neck Shaft Angle, Medico-Legal, Anthropometry and Goniometer

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AB0607 DO HIP STRUCTURAL ANALYSIS MEASUREMENTS PREDICT FRACTURE RISK IN PATIENTS WITH POLYMYALGIA RHEUMATICA?

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.337 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1339.2-1339

Author(s):

R. Ark ◽

M. Bukhari

Keyword(s):

Structural Analysis ◽

Femoral Neck ◽

Fracture Risk ◽

Polymyalgia Rheumatica ◽

Odds Ratio ◽

Regression Models ◽

Hip Structural Analysis ◽

Odds Ratios ◽

Cross Sectional ◽

Shaft Angle

Background:Polymyalgia Rheumatica (PMR) is an inflammatory condition which commonly affects the elderly. Risk of fracture is higher in this group of patients compared to the general population and can lead to increased morbidity and mortality (1). Hip structural analysis (HSA) is a technique that uses dual-energy X-ray absorptiometry (DEXA) images to assess hip bone structure (2).Objectives:To identify whether HSA measurements help predict fracture in patients with PMR.Methods:Data were collected from June 2004 to October 2010 from PMR patients who had a DEXA scan at a District General Hospital. This included hip axis length (HAL), cross-sectional area (CSA), cross-sectional moment of inertia (CSMI), distance from centre of femoral head to centre of femoral neck (D1) and to inter-trochanteric line (D2), mean femoral neck diameter (D3), shaft angle (A) neck/shaft angle (Θ) and proximal femur strength index (SI) and distance from centre of mass of femoral neck to superior neck margin (Y). Fracture was predicted by a series of binomial logistic regression models, adjusted for age and sex. Odds ratios with 95% confidence intervals and area under the receiver operating characteristic curve (AUC) were calculated.Results:714 patients with PMR were identified, 182 were male and the mean age was 70.5. HAL, CSMI, D1, D2, D3, A, Θ, SI and Y were not significant predictors of fracture in regression models; odds ratios are included in Table 1. CSA predicted fracture risk; odds ratio was 0.988 with a 95% confidence interval of 0.980-0.997. The AUC for the CSA regression model was 0.6739.Table 1.Odds ratios of fracture for different HSA parametersHSA ParameterOdds Ratio (95% confidence interval)HAL1.008 (0.982 - 1.035)CSMI1.000 (0.999 - 1.000)CSA0.988 (0.980 - 0.997)D11.029 (0.972 - 1.089)D21.010 (0.981 - 1.040)D31.033 (0.962 - 1.109)Y1.087 (0.966 - 1.223)A0.983 (0.940 - 1.029)Θ1.007 (0.975 - 1.039)SI0.683 (0.406 - 1.150)Conclusion:These data suggest that CSA helps predict the risk of fracture in patients with PMR. HAL, CSMI, D1, D2, D3, A, Θ, SI and Y do not predict fracture risk. Limitations of the study are that it was retrospective and only studied patients who underwent DEXA scans. The study may have been underpowered to detect the impact of some HSA measurements on fracture risk.References:[1]Chatzigeorgiou C, Mackie SL. Comorbidity in polymyalgia rheumatica. Reumatismo. 2018; 70 1:35-43. Available from: http://eprints.whiterose.ac.uk/132109/\\.[2]Kaptoge S, Beck TJ, Reeve J, Stone KL, Hillier TA, Cauley JA, et al. Prediction of Incident Hip Fracture Risk by Femur Geometry Variables Measured by Hip Structural Analysis in the Study of Osteoporotic Fractures. Journal of Bone and Mineral Research. 2008; 23 (12): 1892-1904. Available from: doi: https://doi.org/10.1359/jbmr.080802Disclosure of Interests:None declared.

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Assessment of Femoral Neck-shaft Angle on Plain X-rays and its Clinical Implications

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i47b33191 ◽

2021 ◽

pp. 841-844

Author(s):

N. Adhishwar Kumaran ◽

B. Jagadeesh ◽

Ashok Kumar ◽

K. P. Niveditha

Keyword(s):

Femoral Neck ◽

Neuromuscular Disorders ◽

Local Population ◽

Tertiary Care ◽

X Rays ◽

College Hospital ◽

Cross Sectional ◽

Neck Shaft Angle ◽

Shaft Angle ◽

The Mean

Background: Femoral neck-shaft angle is an important parameter for evaluating the biomechanics of the hip joint. It plays a pivotal role in surgeries for developmental dysplasia of the hip, neuromuscular disorders of the lower limb, proximal femoral fractures, Total Hip Arthroplasty, Perthes disease etc., It is also considered to hold an extensive bearing while designing orthopaedic implants. Aim: This study aimed to evaluate the femoral neck-shaft angle of proximal femur on plain radiographs of our local population Study Design: Retrospective study Methods: This cross-sectional study was done at Saveetha medical college hospital, a tertiary care institute in Chennai. 50 pelvic X-rays of patients aged between 30 to 70 who presented to the outpatient or emergency care department were used in the study. Using a goniometer the femoral neck shaft angle was measured in the plain X - ray. Results: The mean age of the population in our study was 47.12. And the mean femoral neck shaft was 132.6 in males and 124.9 in females.

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The association between femoral neck shaft angle and degenerative disease of the hip in a cadaveric model

Hip International ◽

10.1177/11207000211013029 ◽

2021 ◽

pp. 112070002110130

Author(s):

Leigh-Anne Tu ◽

Douglas S Weinberg ◽

Raymond W Liu

Keyword(s):

Femoral Head ◽

Femoral Neck ◽

Hip Osteoarthritis ◽

Volume Ratio ◽

Femoral Head Coverage ◽

Neck Shaft Angle ◽

Hip Arthritis ◽

Femoral Version ◽

Shaft Angle ◽

The Impact

Background: While the influences of acetabular dysplasia and overcoverage on hip arthritis have been studied, the impact of femoral neck-shaft angle on hip arthritis is much more poorly understood. The purpose of this study is to determine if a relationship exists between neck shaft angle and the development of osteoarthritis, a better understanding of which would be useful to surgeons planning osteotomies about the hip. Methods: 533 cadaveric femora and acetabulae (1066 total) from the Hamann-Todd Osteological Collection (Cleveland, OH) were acquired. We measured true neck shaft angle using an AP photograph with the femoral neck parallel to the table. Femoral head volume to acetabular volume ratio, representing femoral head coverage, as well as femoral version were utilised. Correlation between neck shaft angle, femoral version, femoral head coverage and osteoarthritis were evaluated with multiple regression analysis. Results: The mean age and standard deviation was 56 ± 10 years. There were 64 females (12%) and 469 males. There were 380 Caucasians (71%) and 153 African-Americans. Mean femoral version was 11° ± 12° and mean true neck shaft angle was 127.7° ± 5.9° There was a strong correlation between age and arthritis (standardised beta 0.488, p < 0.001). There was a significant correlation between increasing true neck shaft angle and decreasing hip arthritis (standardised beta -0.024, p = 0.038). In the femoral head overcoverage subset, increasing true neck shaft angle was still significantly associated with decreasing hip arthritis (standardised beta −0.088, p = 0.018), although this relationship was not significant with femoral head undercoverage subset. Conclusions: With sufficient acetabular coverage, a relative increase in femoral neck shaft angle within the physiologic range is associated with decreased hip osteoarthritis. Clinical relevance: An understanding of the relationship between femoral neck shaft angle and hip osteoarthritis could be useful for surgeons planning pelvic or proximal femur osteotomies in children.

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Simultaneous Morscher’s osteotomy and arthroscopic debridement in the management of Legg–Calvé–Perthes disease: a case report and literature review

Journal of Hip Preservation Surgery ◽

10.1093/jhps/hnab017 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. i4-i8

Author(s):

Batool Bosakhar ◽

Hassan Baldawi ◽

Kathy Liu ◽

Olufemi R Ayeni ◽

Waleed Kishta

Keyword(s):

Case Report ◽

Literature Review ◽

Femoral Neck ◽

Perthes Disease ◽

Labral Repair ◽

Coxa Vara ◽

Neck Shaft Angle ◽

Shaft Angle ◽

Outcome Tool

Abstract There is a lack of consensus around optimal surgical management for Legg–Calvé–Perthes Disease (LCPD). This case report discusses the benefits of combining arthroscopic femoral neck osteochondroplasty and labral repair with Morscher’s Osteotomy (MO) for LCPD. S.A. is a 17-year-old female diagnosed with LCPD at the age of 6 years and has long-standing right hip symptoms. An arthroscopic femoral neck osteochondroplasty and labral repair followed by MO was performed. The pre-operative and 8 months post-operative International Hip Outcome Tool (iHOT-12) scores were 16.3 and 79.8 out of 100, respectively, indicating better quality-of-life. Also, the femoral neck-shaft-angle (NSA) changed from 120 pre-operative to 138.7 post-operative to represent the correction of coxa vara. The literature review revealed no published reports describing combined MO with hip arthroscopic interventions in managing LCPD. Combined arthroscopic femoral neck osteochondroplasty (with labral repair) and MO provides high patient satisfaction and improves radiographic parameters in patients with LCPD.

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