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

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.

scholarly journals Standard Radiographic Assessment of Femoral Cam Morphology is Influenced by Neck-Shaft Angle and Femoral Version

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0039
Author(s):  
Layla Haidar ◽  
Ryan Warth ◽  
Erinn Pemberton Annie Waite ◽  
Alfred Mansour
Keyword(s):  
Femoral Head ◽  
Alpha Angle ◽  
Three Dimensional ◽  
Neck Shaft Angle ◽  
Incremental Change ◽  
Observer Reliability ◽  
Angle Measurements ◽  
Femoral Version ◽  
Shaft Angle ◽  
Head Neck

Objectives: Cam-type femoroacetabular impingement (FAI) is a three-dimensional (3D) deformity that is still difficult to assess using traditional two-dimensional (2D) radiographic views. While measurements of alpha angle and head-neck offset are used to estimate the likelihood of actual impingement, these 2D measurements do not account for z-axis variations in femoral version (FV) and neck-shaft angle (NSA). The purpose of this qualitative proof-of-concept study was to evaluate the potential variation in alpha angle and neck-shaft offset measurements with incremental changes in NSA and FV by simulating traditional radiographic views with software-generated Digitally-Reconstructed Radiographs (DRRs). We hypothesize that incremental changes in hip morphology will produce qualitative changes in alpha angle and neck-shaft offset. Methods: 3D-CT reconstruction images were obtained from one subject with symptomatic cam-type FAI. The 3D reconstruction was cleaned to include only the femoral head, neck and subtrochanteric region along with the ipsilateral hemipelvis. Using 3D medical image processing software (Mimics; Materialise, Inc.; Belgium), the pre-processed 3D model was manipulated in a standardized manner to simulate 5-degree incremental variations in FV and NSA (-15 degrees to +15 degrees for FV; -15 degrees to +10 degrees for NSA). Negative FV reflected external rotation of the femoral head-neck unit, whereas negative NSA reflected abduction of the femoral head-neck unit. Each modified 3D model was then used to generate DRRs corresponding to traditional 2D radiographic views used for assessment of cam-FAI (Anteroposterior [AP], False Profile [FP]), Cross Table Lateral [CTL], Frog Leg Lateral [FLL], 45- and 90-degree Dunn [45D and 90D, respectively]. Alpha angle and head-neck offset were measured on each radiographic view corresponding to each incremental change in FV and NSA. All measurements utilized the perfect circle technique and were made by two independent observers for assessment of inter-observer reliability. Two-way random effects ANOVA was used for statistical assessment of inter-observer reliability and reported as intra-class correlation coefficients (κ). Comparisons between groups were performed using two-tailed paired t-tests assuming unequal variance. P-values less than 0.05 were considered statistically significant. Results: Inter-observer reliability (κ) for head-neck offset and alpha angles were 0.46 (fair) and 0.88 (excellent), respectively. Variations in head-neck offset and alpha angle with incremental variations in FV and NSA are summarized in Figure 1. There were statistically significant changes in mean alpha angles when the NSA was adjusted from Neutral to -5 degrees (p=0.01) and from -5 degrees to -10 degrees (p<0.001). There were no statistically significant differences in alpha angles or head-neck offsets between each incremental change in FV (p<0.05). Alpha angle measurements were significantly more variable than head-neck offset measurements for all variations in FV (p<0.001) and NSA (p=0.02) (Figure 2). Conclusion: Two-dimensional evaluation of three-dimensional Cam morphology (alpha angle and head-neck offset) was found to be significantly affected by alterations in femoral version and head-neck offset. Head-neck offset measurements were significantly less variable than alpha angle measurements across all FVs and NSAs within each radiographic view. Future work should be done to develop standardized procedures for routine 3D radiographic assessment of cam-type FAI. [Figure: see text][Figure: see text]

Femoral Neck Shaft Angle is Not Correlated with Femoral Version: A Retrospective Study of Computed Tomography Scans

Injury ◽  
2021 ◽  
Author(s):  
Patrick J. Kellam ◽  
Miranda J. Rogers ◽  
Luke Myhre ◽  
Graham J. Dekeyser ◽  
Travis G. Maak ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Retrospective Study ◽  
Femoral Neck ◽  
Neck Shaft Angle ◽  
Femoral Version ◽  
Computed Tomography Scans ◽  
Shaft Angle

scholarly journals Radiographic analysis of the proximal femoral anatomy in the Croatian population

2021 ◽  
Author(s):  
Hrvoje Mokrovic ◽  
Simona Komen ◽  
Leo Gulan ◽  
Gordan Gulan
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Radiographic Evaluation ◽  
Neck Length ◽  
Femoral Offset ◽  
Head Diameter ◽  
Neck Shaft Angle ◽  
Femoral Neck Anteversion ◽  
Femoral Head Diameter ◽  
Shaft Angle

Abstract Purpose The goal of total hip endoprosthesis is to achieve painless and functional hip for long term. Accurate reconstruction of hip anatomy largely depends on the implant design. In order to select an implant in correspondence with the native hip, the proximal femoral morphology has been in focus of many studies in the past years. The purpose of this study is to analyze proximal femoral geometry in the Croatian population by radiographic evaluation. Methods We conducted a retrospective study analyzing conventional radiographies of the hip, obtained within the last four years from the database of Clinic for Orthopaedic Surgery Lovran. The number of studied patients was 300,168 women and 132 men. The proximal femoral geometric parameters assessed were as follows: femoral head diameter, femoral neck length, neck-shaft angle, angle of femoral neck anteversion, and lateral femoral offset. The results obtained were compared between genders and with results of other studies. Results Proximal femoral anatomy differed in femoral head diameter and lateral femoral offset between males and females in our group of patients, while femoral neck length, femoral neck shaft angle, and femoral neck anteversion have shown similar values in both genders. Our study also showed specificity of the Croatian population in almost all parameters of proximal femoral anatomy, in comparison with other ethnic groups. Conclusion Our results support the observation on high diversity in the morphology of the proximal femur and the specificity of the proximal femoral anatomy of the Croatian population.

scholarly journals Femoral neck shaft angle in relation to the location of femoral stress fracture in young military recruits: femoral head versus femoral neck stress fracture

2020 ◽  
Author(s):  
Dong-Kyu Kim ◽  
Tae Ho Kim
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Stress Fracture ◽  
Roc Analysis ◽  
Fracture Group ◽  
Neck Shaft Angle ◽  
Group A ◽  
Femoral Neck Stress Fracture ◽  
Shaft Angle ◽  
Group B

Abstract Objective To evaluate the influences of the femoral neck shaft angle (FNSA) on the location of the femoral stress fracture and to assess the potential differences in FNSA between fractured and normal femurs. Materials and methods Thirty-seven patients with femoral stress fractures who underwent both plain hip radiographs and MRI, from January 2016 to September 2019, were retrospectively included. Patients were classified as having either femoral head stress fracture (group A, n = 26) or femoral neck stress fracture (group B, n = 11). The FNSA was measured in anteroposterior (AP) hip radiograph. The Mann-Whitney U testing was used to compare the continuous values between the two groups. A receiver operating characteristic (ROC) analysis was used to evaluate the value of FNSA for predicting the risk of femoral stress fracture. Results The FNSA was significantly higher in group A (median 135.9°, range 129.5–138.6°) than group B (median 124.3°, range 119.5–129.0°) (p < 0.001), but there were no significant differences in other clinical factors. Furthermore, the FNSA was significantly higher at the fractured femurs (median 135.9°, range 129.9–138.6°) than contralateral normal femurs (median 127.9°, range 123.8–132.1°) in the patients with unilateral femoral head stress fracture (n = 22) (p < 0.001). The ROC analysis revealed that the area under curve (AUC), sensitivity, and specificity for predicting the risk of femoral head stress fracture were 0.807, 72.7%, and 68.2%, respectively, at a FNSA cutoff of 131.0°. Conclusion FNSA was associated with the location of the femoral stress fracture. In addition, FNSA could serve as a predictive factor for the risk of femoral head stress fractures.

scholarly journals Nonspherical femoral head shape (pistol grip deformity), neck shaft angle, and risk of hip osteoarthritis: A case-control study

2008 ◽  
Vol 58 (10) ◽  
pp. 3172-3182 ◽  
Author(s):  
Michael Doherty ◽  
Philip Courtney ◽  
Sally Doherty ◽  
Wendy Jenkins ◽  
Rose A. Maciewicz ◽  
...  
Keyword(s):  
Femoral Head ◽  
Case Control Study ◽  
Hip Osteoarthritis ◽  
Case Control ◽  
Head Shape ◽  
Neck Shaft Angle ◽  
Shaft Angle ◽  
Control Study

scholarly journals Femoral Version, Neck-Shaft Angle, and Acetabular Anteversion in Chinese Han Population

Medicine ◽  
2015 ◽  
Vol 94 (21) ◽  
pp. e891 ◽  
Author(s):  
Nan Jiang ◽  
Lin Peng ◽  
Mohammed Al-Qwbani ◽  
Guo-Ping Xie ◽  
Qin-Meng Yang ◽  
...  
Keyword(s):  
Chinese Han Population ◽  
Acetabular Anteversion ◽  
Chinese Han ◽  
Han Population ◽  
Neck Shaft Angle ◽  
Femoral Version ◽  
Shaft Angle

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

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.

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

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

Morphometric Study of Femoral Neck-Shaft Angle in Kolar Population and Its Clinical Importance

2019 ◽  
Vol 8 (3) ◽  
pp. 226-232
Author(s):  
Suresh NM ◽  
◽  
Sunitha R ◽  
Aruna N ◽  
Nalini JP ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Clinical Importance ◽  
Morphometric Study ◽  
Neck Shaft Angle ◽  
Shaft Angle

scholarly journals Comparison of four parameters to assess acetabular dysplasia and acetabular dysplasia rates in primary hip osteoarthritis patients: A study in Turkish population

2018 ◽  
Vol 26 (2) ◽  
pp. 230949901876803 ◽  
Author(s):  
Oktay Adanir ◽  
Gazi Zorer
Keyword(s):  
Femoral Head ◽  
Acetabular Dysplasia ◽  
Hip Prosthesis ◽  
Hip Osteoarthritis ◽  
High Rate ◽  
Femoral Head Coverage ◽  
Coverage Ratio ◽  
Total Hip ◽  
Center Edge ◽  
Age At Surgery

Introduction: Hip osteoarthritis is an important orthopedic problem frequently observed in the elderly. Acetabular dysplasia (AD) is one of the pathologies that cause coxarthrosis. Nearly 20–45% of primary or idiopathic hip osteoarthritis is linked to AD. In our country, there are few studies on this topic. We measured the center–edge (CE) angle, Sharp’s angle, acetabular depth, and femoral head coverage ratio on pelvis anteroposterior radiographs of patients with primary coxarthrosis and calculated the dysplasia rates. Patients and method: Age at surgery and sex of the patients; and CE angle, Sharp’s angle, acetabular depth, and femoral head coverage ratio for both operated and opposite hips were evaluated in 223 total hip prosthesis–performed patients with coxarthrosis. Also the distribution of mean age at surgery, sex of patients, dysplasia rates of operated hips, and bilateral dysplasia rates were calculated. Results: The right to left ratio of operated hips was 104/119. Female to male ratio was 163/60 (2.7/1), for those with CE angle below 20° it was 123/30 (4.1/1), and it was 40/30 (1.3/1) with CE angle above 20°. Mean age of patients at surgery was 56.9 (±11.4) years. CE angle less than 20° was found in 68.6% of patients, acetabulum depth less than 9 mm was found in 75.3%, Sharp’s angle was more than 45° in 65.9%, and femoral head coverage ratio was less than 70% in 70.3% of patients. Conclusions: We identified a high rate of AD in primary coxarthrosis patients undergoing total hip arthroplasty in the study population.

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