scholarly journals The distance of the centre of femoral head relative to the midline of the pelvis: a prospective X-ray study of 500 adults

2017 ◽  
Vol 3 (3) ◽  
pp. 565
Author(s):  
Yash B. Rabari ◽  
Amol Sanap ◽  
D. V. Prasad ◽  
Krunal H. Thadeshwar
Keyword(s):  
Femoral Head ◽  
Mechanical Axis ◽  
X Ray ◽  
Patient Gender ◽  
Gender And Age ◽  
Total Knee ◽  
Measured Distance ◽  
Anteroposterior View ◽  
The Mean ◽  
Femoral Head Center

<p class="abstract"><strong>Background:</strong> The mechanical axis of the femur is defined as the line joining the centre of the femoral head to the centre of the knee joint. One of the pre-requisites for a successful total knee replacement (TKR) is correct positioning of the implants, so that the mechanical axis of the limb is restored to neutral. During TKR surgery, the distal femoral anatomy can be visualized. However, to identify the mechanical axis of the femur, the location of the femoral head must be known.</p><p class="abstract"><strong>Methods:</strong> We prospectively measured distance of centre of femoral head relative to the midline of the pelvis in 500 adults, using x ray of pelvic with both hip anteroposterior view done for medical causes during 2-May-2015 to 1-Jan-2017 with satisfied the following inclusion and exclusion criteria. Patient gender and age were known. Both hips were clearly shown on the radiograph and not affected by any developmental or acquired condition that might deform normal anatomy. Radiographs demonstrating unacceptable pelvic tilt or rotation were excluded. Also, we excluded any cases where degenerative changes in the native hip were more severe than grade 1, based on the Tönnis classification.<strong></strong></p><p class="abstract"><strong>Results:</strong> There were total 500 patients in which 250 were male and 250 were female. The mean age of male was 52.14 year (SD ±80.80 mm, 95% CI 51.05 to 53.24 mm) and female was 52.11 years (SD ±8.82 mm, 95% CI 51.01 to 53.24 mm).The mean distance of femoral head centre from midline in male was 95.02mm (SD ±2.20 mm, 95% CI 94.75 to 95.30 mm) and in female was 91.54 mm (SD ±2.64 mm, 95% CI 91.22 to 91.87 mm).</p><strong>Conclusions:</strong>This study provide a useful information to determine the femoral head center relative to the midline of pelvis which useful intraoperatively. <p> </p>

scholarly journals Femoral head diameters in Nepalese patients undergoing hemiarthroplasty

2021 ◽  
Vol 7 (6) ◽  
pp. 1190
Author(s):  
Manoj P. Gupta ◽  
Lokraj Chaurasia ◽  
Sanjeet Kumar Jha
Keyword(s):  
Femoral Head ◽  
P Value ◽  
Head Diameter ◽  
X Ray ◽  
Femoral Head Diameter ◽  
Radiological Measurements ◽  
Anteroposterior View ◽  
Male Patients ◽  
The Mean ◽  
Geographical Locations

<p class="abstract"><strong>Background:</strong> Sizing of the femoral head is important for determining the appropriate size of implants to be used for a patient undergoing hip arthroplasty. The present study aimed to determine the mean diameter of femoral head in Nepalese population who underwent hemiarthroplasty in our department.</p><p class="abstract"><strong>Methods:</strong> We retrospectively reviewed the medical records of patients who underwent hemiarthroplasty from December 2016 till December 2020. We included patients aged more than 50 years who underwent hemiarthroplasty. The diameter of the femoral head was measured intraoperatively using standard fully circular templates. For radiological measurements, X-ray of pelvis with hips anteroposterior view were included.<strong></strong></p><p class="abstract"><strong>Results:</strong> A total of 600 femoral heads were evaluated, 400 of women and 200 of men. Of these cases, the femoral head diameter were evaluated based on x-ray pelvis in 500 cases and rest of the 100 cases were evaluated intraoperatively. The mean age of the patients in our sample was 75.2±9.4 (range 50–90) years. Overall, the mean femoral head diameter (with intact articular cartilage) was 44.9±3.2 (range 39–53 mm) mm. Among the male patients, mean femoral head diameter was 47.7±2.8 mm, which was found to be significantly higher than that of female patients, who had a mean femoral head diameter of 43.7±2.4 mm, p value &lt;0.05.</p><p class="abstract"><strong>Conclusions:</strong> Further studies are needed in other geographical locations, so that reference values could be established for specific regions.</p>

scholarly journals Changes in the Ankle Joint and Hindfoot Alignment Following Varus Deformity Correction of the Knee with Total Knee Arthroplasty

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0000
Author(s):  
Bi O Jeong ◽  
Jong Hun Baek ◽  
Wookjae Song
Keyword(s):  
Knee Joint ◽  
Ankle Joint ◽  
Mechanical Axis ◽  
Deformity Correction ◽  
Varus Deformity ◽  
Valgus Deformity ◽  
Hindfoot Alignment ◽  
Total Knee ◽  
The Mean ◽  
Surface Angle

Category: Ankle, Hindfoot Introduction/Purpose: Compensatory changes occur in the ankle joint and the subtalar joint of the hindfoot to maintain neutral alignment in coronal plane when varus or valgus deformity is present in the knee joint. The purpose of this study is (1) to analyze how the ankle and hindfoot joint compensate the changes in mechanical axis that occur with varus deformity of the knee, (2) to analyze the changes in ankle and hindfoot joint alignment when mechanical axis alignment is corrected by correction of varus deformity of the knee with total knee arthroplasty (TKA), and (3) to radiographically evaluate the degree of changes in ankle and hindfoot joint alignment according to the degree of varus deformity correction. Methods: 375 knees that underwent TKA with varus deformity were prospectively studied. The degree of varus deformity of the knee joint was measured in standing long leg anteroposterior views taken before and 6 months after TKA. The angle between the ground surface and the superior dome of the talus, and the talar tilt were measured in standing ankle joint anteroposterior views taken before and 6 months after TKA. Preoperative tibial anterior surface angle and tibial lateral surface angle were measured. Hindfoot alignment was evaluated in hindfoot alignment views taken before and 6 months after operation by measuring the heel ratio, the heel angle, and the heel distance. These measurements were used to analyze the change in ankle joint and hindfoot alignment between before and 6 months after varus deformity correction. The relationship between the degree of varus knee correction and the change in ankle joint and hindfoot alignment was also analyzed. Results: The mean mechanical angle of the knee changed from varus 10.6±5.1° before operation to varus 0.1±3.2° after operation, which was statistically significant (P<0.001). The mean correction angle was 10.6±4.6°. Before operation, the mean tibial anterior surface angle was 89.9±3.1° and the mean tibial lateral surface angle was 81.5±2.9°. Talar tilt changed significantly from 0.3±2.0° to 0.0±1.6°, implying a varus change of the ankle joint (P=0.002). All of the evaluated hindfoot alignment parameters demonstrated a significant varus change (P<0.001), as the heel ratio changed from 0.2±0.2 preoperatively to 0.3±0.2 postoperatively (P<0.001), the heel angle changed from 11.4±7.0° preoperatively to 5.0±7.4°postoperatively (P<0.001), and the heel distance changed from 10.5±6.6 mm preoperatively to 6.4±6.4 mm postoperatively (P<0.000). Conclusion: Varus knee deformity tended to be associated with valgus deformity of the ankle joint and hindfoot alignment. Alignment in the ankle joint and the hindfoot both changed to a varus trend after correction of varus deformity of the knee. Such changes in ankle joint and hindfoot alignment are considered to be due to the compensatory changes following alterations in lower limb alignment. Therefore, it is necessary to perform a meticulous examination of the ankle joint as well as the knee joint and consider subsequent alteration of ankle joint and hindfoot alignment before surgical correction of knee joint alignment.

scholarly journals Comparison of early results of total knee replacement performed with Zimmer iASSIST versus conventional technique

2020 ◽  
Vol 27 (2) ◽  
pp. 208-213
Author(s):  
Ho Yeung Cyrus Lai ◽  
Yan Ho Bruce Tang ◽  
Hok Leung Wong
Keyword(s):  
Blood Loss ◽  
Tibial Component ◽  
Mechanical Axis ◽  
Operation Time ◽  
Conventional Technique ◽  
Coronal Alignment ◽  
Posterior Slope ◽  
Total Knee ◽  
The Mean ◽  
Hemoglobin Drop

Background: Zimmer iASSIST knee is an accelerometer-based navigation system with the aim of achieving better alignment in total knee arthroplasty (TKA). We have started using this system since early 2016. This is a retrospective case–control study, which aims to compare the radiological alignment, operation time, and blood loss of TKAs performed using the iASSIST system and those using conventional techniques. Materials and Methods: 42 TKAs using Zimmer iASSIST and 44 TKAs using conventional instrumentation were recruited. The overall coronal alignment and the coronal and sagittal alignment of the femoral and tibial component were compared. For coronal alignment, additional analysis of the absolute deviation from neutral mechanical axis was performed to avoid canceling out of varus/valgus deviation. The number of outliers, operation time, and blood loss in terms of maximal hemoglobin drop were also compared. Results: When comparing the alignment of the iASSIST group with the conventional group, there were no significant differences ( p > 0.05) in the number of outliers, mean coronal alignments, mean deviation from neutral coronal mechanical axis (2.9° vs. 2.9°), and femoral component flexion angle (4.9° vs. 4.7°). The difference in the mean tibial component posterior slope was significant (5.7° vs. 7.1°, p < 0.05). The mean operation time was significantly longer by 13 min ( p < 0.05) in the iASSIST group. There were no significant differences in the mean hemoglobin drop between the two groups. Conclusion: The results demonstrated no significant differences in terms of coronal radiological alignment, femoral flexion angle, outliers, and blood loss between iASSIST and conventional technique. There was a small but statistically significant difference in tibial posterior slope. The iASSIST group needed a longer operation time.

scholarly journals Difference between Mechanical Alignment in Navigation and Scanogram during Total Knee Arthroplasty

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Rohan Bhimani ◽  
Fardeen Bhimani ◽  
Preeti Singh
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Mechanical Axis ◽  
Computer Navigation ◽  
Primary Total Knee Arthroplasty ◽  
P Value ◽  
Mechanical Alignment ◽  
Significant Difference ◽  
Total Knee ◽  
The Mean

Introduction. Malpositioning of the implant results in polyethylene wear and loosing of implant after total knee arthroplasty. Scanogram is often used for measurement of limb alignment. Computer navigation provides real time measurements and thus, the aim is to see any association pre- and postoperatively between coronal alignments measured on scanogram to computer navigation during total knee arthroplasty. Material and Methods. We prospectively gathered data of 200 patients with advanced degenerative symptomatic arthritis, who were consecutively selected for primary total knee arthroplasty with computer navigation. Every patient’s pre- and postoperative scanogram were compared to the intraoperative computer navigation findings. Results. The results show that the preoperative mean mechanical axis on navigation was 10.65° (SD ± 6.95) and on scanogram it was 10.38° (SD ± 6.89). On the other hand, the mean postoperative mechanical axis on navigation was 0.69° (SD ± 0.87) and on scanogram it was 2.73° (SD ± 2.10). Preoperatively, there was no significant difference (p value = 0.46) between the two. However, the postoperative outcomes suggest that there was a noteworthy difference, with no correlation between the mean Hip-Knee Ankle Axis (HKA) and intraoperative mechanical axis (p value <0.0001). Conclusion. Postoperative mechanical alignment values after total knee arthroplasty are lower on navigation than measured on standing full length hip to ankle scanogram.

scholarly journals DESCRIPTION OF A NEW METHOD OF MEASURING THE PELVIC INCIDENCE ANGLE THROUGH COMPUTED TOMOGRAPHY

2020 ◽  
Vol 19 (1) ◽  
pp. 30-33
Author(s):  
MURILO TAVARES DAHER ◽  
RENATO FLEURY DI SOUZA LOPES ◽  
RENATO TAVARES DAHER ◽  
RICARDO TAVARES DAHER ◽  
NILO CARRIJO MELO ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Femoral Head ◽  
Pelvic Incidence ◽  
Incidence Angle ◽  
Accurate Method ◽  
Diagnostic Study ◽  
Lumbosacral Region ◽  
Level Of Evidence ◽  
X Ray ◽  
The Mean

ABSTRACT Objective To describe a more accurate method for measuring the pelvic incidence angle using computed tomography, without the influence of the positioning of the pelvis in relation to the X-ray tube. Methods Thirteen CT scans of the lumbosacral region, abdomen or pelvis were randomly assessed, as all these exams include the sacrum and femoral heads. All the exams were performed in multichannel devices with six channels. The technique of overlapping images, already common in other musculoskeletal exams, such as TT-TG, was used. The centered sagittal cut of the left femoral head, the center of S1, and the right femoral head were used. From these, a fourth image was created, analogous to an X-ray of the pelvis, from which measurements were taken using the dedicated software. Results Of the thirteen exams, three were of the lumbar spine and 10 were of the total abdomen, six of them being of males.. The mean age was 56 years. The mean PI was 45°, ranging from 31 to 81 degrees. Among the women, the mean was 52° (31 to 81°) and among the men, 38° (32 to 46°). Conclusion CT can be used to calculate the PI, using the technique of overlapping images common to other musculoskeletal exams, such as TT-TG. Level of Evidence IIIB. Diagnostic study; Retrospective study.

scholarly journals Vital Protocol for Reliability and Accuracy of PolyWareTM Measurements

2021 ◽  
Author(s):  
Jong Min Lee ◽  
Seung-Hoon Baek ◽  
Yeon Soo Lee
Keyword(s):  
Femoral Head ◽  
Edge Detection ◽  
Polyethylene Wear ◽  
Measurement Tool ◽  
Acetabular Anteversion ◽  
Error Sources ◽  
X Ray ◽  
Beam Center ◽  
Femoral Head Center ◽  
Imaging Conditions

Abstract Introduction: PolyWareTM software (PW) has been an exclusively used software in most polyethylene wear studies of total hip arthroplasty (THA). We found that PolyWareTM (PW) measurements can be significantly inaccurate and unrepeatable depending on imaging conditions or subjective manipulation choices. In this regard, this study reveals the required conditions to achieve the best accuracy and reliability of the PW measurements.Results: Among all the imported X-ray images, those with a resolution of 1076×1076 exhibited the best standard deviation in wear measurements as small as 0.01 mm and the least occurrences of blurriness. The edge detection area specified as non-squared and off the femoral head center exhibited the most occurrence of blurriness. At the X-ray scanning moment, an eccentric placement of the femoral head center by 15 cm superior to the X-ray beam center led to an acetabular anteversion measurement error up to 5.3°.Conclusion: Because PW has been an exclusively used polyethylene wear measurement tool, revealing its error sources and making the countermeasure are of great importance. The results request researchers to observe the following conditions; 1) the original X-ray image be 1076×1076 squared X-ray images, 2) the edge detection area be specified as a square with edge lengths of 5 times the diameter of the femoral head centered at the femoral head center, 3) the femoral head center or acetabular center be placed as close to the center line of the X-ray beam as possible, at the X-ray scanning moment.

scholarly journals Vital Protocol for Reliability and Accuracy of PolyWareTM Measurements

2021 ◽  
Author(s):  
Jong min Lee ◽  
Seung-Hoon Baek ◽  
Yeon Soo Lee
Keyword(s):  
Femoral Head ◽  
Edge Detection ◽  
Polyethylene Wear ◽  
Center Line ◽  
Acetabular Anteversion ◽  
X Ray ◽  
Beam Center ◽  
Femoral Head Center ◽  
Imaging Conditions

Abstract Background: PolyWareTM software (PW) has been exclusively used in most of the polyethylene wear studies of total hip arthroplasty (THA). But, we found that PolyWareTM (PW) measurements can be significantly inaccurate and unrepeatable depending on imaging conditions or subjective manipulation choices. In this regard, this study reveals the required conditions to achieve the best accuracy and reliability of the PW measurements.Methods: The experiment examined the dependency of PW on several measurement conditions. The X-ray images of in-vitro THA prostheses were acquired under a clinical X-ray scanning condition. A liner wear of 6.67 mm, an acetabular lateral inclination of 36.7° and an anteversion of 9.0° were simulated.Results: Among all the imported X-ray images, those with a resolution of 1076×1076 exhibited the best standard deviation in wear measurements as small as 0.01 mm and the least occurrences of blurriness. The edge detection area specified as non-squared and off the femoral head center exhibited the most occurrence of blurriness. At the X-ray scanning moment, an eccentric placement of the femoral head center by 15 cm superior to the X-ray beam center led to an acetabular anteversion error up to 5.3°.Conclusion: The results request researchers to observe following conditions; 1) the original Xray image be 1076×1076 squared X-ray images, 2) the edge detection area be specified as a square with edge lengths of 5 times the diameter of the femoral head centered at the femoral head center, 3) the femoral head center or acetabular center be placed as close to the center line of the X-ray beam as possible, at the X-ray scanning moment.

The influence of early radiolucent lines appearing on femoral head penetration into HXLPE cemented sockets

2018 ◽  
Vol 28 (4) ◽  
pp. 369-374
Author(s):  
Daigo Morita ◽  
Taisuke Seki ◽  
Yoshitoshi Higuchi ◽  
Yasuhiko Takegami ◽  
Takafumi Amano ◽  
...  
Keyword(s):  
Femoral Head ◽  
Wear Rate ◽  
Postoperative Phase ◽  
Wear Rates ◽  
Head Penetration ◽  
Radiolucent Lines ◽  
Anteroposterior View ◽  
The Mean ◽  
Distribution Of Stress ◽  
Femoral Head Penetration

Introduction: This study investigates differences in femoral head penetration between highly cross-linked polyethylene (HXLPE) cemented sockets both with and without radiolucent lines (RLLs) in the early postoperative phase and at 5 years follow-up. Methods: There were 35 patients (37 hips), mean age of 66.8 years, who underwent total hip arthroplasty (THA) using highly HXLPE cemented sockets. They were divided into 2 groups based on postoperative the early appearance of RLLs. Femoral head penetrations on both anteroposterior- and Lauenstein-view radiographs were evaluated, and the mean polyethylene (PE) wear rate was calculated based on femoral head penetrations between 2 and 5 years. Results: Femoral head penetrations in the proximal direction were 0.075 mm and 0.150 mm in the RLL and non-RLL groups at 1 year postoperatively ( p = 0.019). At 5 years measured penetration was 0.107 mm and 0.125 mm in the RLL and non-RLL groups, respectively ( p = 0.320). The mean PE wear rates in anteroposterior-view were 0.008 mm/year and 0.003 mm/year in the RLL and non-RLL groups ( p = 0.390) and those in Lauenstein-view were 0.010 mm/year and 0.005 mm/year, respectively ( p = 0.239). Conclusions: In the RLL group, the PE bedding-in was less compared with those in the non-RLL group. Additionally, the mean PE wear rate in the RLL group tended to be higher than that in the non-RLL group. The distribution of stress loading through the cement may differ according to whether early RLLs appear.

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