Femoral head diameters in Nepalese patients undergoing hemiarthroplasty

Background: 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.Methods: 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.Results: 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 <0.05.Conclusions: Further studies are needed in other geographical locations, so that reference values could be established for specific regions.

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

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20171902 ◽

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

Background: 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.Methods: 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.Results: 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).Conclusions:This study provide a useful information to determine the femoral head center relative to the midline of pelvis which useful intraoperatively.

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Robotic-Arm Assisted Total Hip Arthroplasty Results in Smaller Acetabular Cup Size in Relation to the Femoral Head Size: A Matched-Pair Controlled Study

Hip International ◽

10.5301/hipint.5000418 ◽

2017 ◽

Vol 27 (2) ◽

pp. 147-152 ◽

Cited By ~ 12

Author(s):

Carlos Suarez-Ahedo ◽

Chengcheng Gui ◽

Timothy J. Martin ◽

Sivashankar Chandrasekaran ◽

Parth Lodhia ◽

...

Keyword(s):

Femoral Head ◽

Head Size ◽

Robotic Arm ◽

Matched Pair ◽

Femoral Head Size ◽

Acetabular Cup ◽

Acetabular Bone ◽

Head Diameter ◽

Total Hip ◽

Femoral Head Diameter

Purpose To compare the acetabular component size relative to the patient's native femoral head size between conventional THA (CTHA) approach and robotic-arm assisted THA (RTHA) to infer which of these techniques preserved more acetabular bone. Methods Patients were included if they had primary osteoarthritis (OA) and underwent total hip replacement between June 2008 and March 2014. Patients were excluded if they had missing or rotated postoperative anteroposterior radiographs. RTHA patients were matched to a control group of CTHA patients, in terms of preoperative native femoral head size, age, gender, body mass index (BMI) and approach. Acetabular cup size relative to femoral head size was used as a surrogate for amount of bone resected. We compared the groups according to 2 measures describing acetabular cup diameter ( c) in relation to femoral head diameter ( f): (i) c-f, the difference between cup diameter and femoral head diameter and (ii) ( c-f)/ f, the same difference as a fraction of femoral head diameter. Results 57 matched pairs were included in each group. There were no significant differences between groups for demographic measures, femoral head diameter, or acetabular cup diameter (p>0.05). However, measures (i) and (ii) did differ significantly between the groups, with lower values in the RTHA group (p<0.02). Conclusions Using acetabular cup size relative to femoral head size as an approximate surrogate measure of acetabular bone resection may suggest greater preservation of bone stock using RTHA compared to CTHA. Further studies are needed to validate the relationship between acetabular cup size and bone loss in THA.

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Observations on radiological correction of acetabular dysplasia by Dega transiliac osteotomy

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20171831 ◽

2017 ◽

Vol 5 (5) ◽

pp. 1991

Author(s):

Wazir Fahad Jan ◽

Sanjay Sarup ◽

Mohd Yahya Dar ◽

Alamgir Jahan ◽

Ovais Nazir Khan

Keyword(s):

Acetabular Dysplasia ◽

Mean Value ◽

P Value ◽

Preoperative Period ◽

Radiological Parameters ◽

Male Patients ◽

The Mean ◽

Paediatric Orthopaedic ◽

Age Range

Background: Several osteotomies have been described for the correction of acetabular dysplasia associated with variable outcomes. The purpose of our study was to evaluate the effect of Dega transiliac osteotomy in radiological correction of acetabular dysplasia by assessing the change in various radiological parameters from preoperative period to postoperative period and at a follow up of two years.Methods: This was a prospective observational study conducted on 35 patients of either sex, in the age range of 18 months to 8 years, presenting to the paediatric orthopaedic OPD, of Artemis Health Institute, Gurgaon, Haryana, India between January 2012 and September 2014 in whom a diagnosis of acetabular dysplasia was made. All the patients underwent Dega transiliac osteotomy and the effectiveness of this osteotomy in the correction of acetabular dysplasia was assessed by measuring various radiological parameters preoperatively, postoperatively, and at a follow up of two years. The various radiological parameters included acetabular index (AI), centre edge angle of wiberg (CEAW), reimer’s extrusion index (REI) and the shenton’s line (SL).Results: In present study sample of 35 cases, 29 had DDH, 4 were secondary to cerebral palsy and 2 had developed dysplasia following septic arthritis of the hip. The sex distribution showed 19 females and 16 male patients. All the patients underwent Dega transiliac osteotomy at a mean age of 42.94±21.68 months. The mean value of AI improved from 42.43±4.77 degrees in preoperative period to 19.86±2.45 degrees at follow up. The mean value of CEAW improved from - 32.49±21.60 degrees in preoperative period to 32.06±5.48 degrees at follow up. The mean value of REI, improved from 91.06±21.43 % in preoperative period to 0.29±1.18 % at follow up. The SL was broken in all the 35 patients preoperatively, while at follow up it was continuous in all the patients. These changes in all the four parameters were statistically highly significant (p value<0.001).Conclusions: Thus results of present study demonstrate that Dega osteotomy is a safe, effective and versatile surgical procedure for the treatment of acetabular dysplasia secondary to DDH and other disorders. Since the majority of the patients included in this study had the diagnosis of DDH, the results of this study are more representative of dysplasia associated with DDH.

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