Does Proximal Hip Geometry Affect Fracture Type in The Elderly Population?

Abstract Background The aim of this study was to determine the differences in proximal femoral geometric (PFG) parameters between patients with femoral neck fractures(FNFs) and patients with intertrochanteric fractures (ITFs). Methods We retrospectively evaluated 114 patients (33 FNFs, 81 ITFs.) who were hospitalized secondary to hip fractures. Patients were divided into two groups: patients with FNFs and patients with ITFs. The PFG parameters (the neck shaft angle, center-edge angle, femoral head diameter, femoral neck diameter, neck/head ratio, femoral neck axial length, femoral shaft diameter, hip axial length, and neck/hip length ratio) were measured on the hip joint radiographs. Results There were no statistically significant differences in age and gender between the FNF and ITF groups. In addition, there were no statistically significant differences in the PFG parameters between the FNF and ITF groups except in the neck/hip length ratio (NHLR) (0.86 ± 0.03 vs 0.84 ± 0.03, p = 0.05). When a 3-way multivariate analysis was performed according to gender, fracture type, and fracture site, the femoral head diameter, femoral neck diameter, femoral neck axial length, femoral shaft diameter, hip axial length, and NHLR were found to be greater in females than in males, and a statistically significant relationship was found between gender and these variables. Conclusion Only the NHLR was significantly higher in the ITF group, so this study revealed that a higher NHLR, which is the presence of a longer hip axis combined with a shorter neck axis, is a risk factor for ITF after a minor trauma.

Download Full-text

Radiographic analysis of the proximal femoral anatomy in the Croatian population

International Orthopaedics ◽

10.1007/s00264-021-04942-5 ◽

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.

Download Full-text

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.

Download Full-text