Original ArticleProximal Femoral Geometry: A Radiological Assessment
Section snippets
Methods
One hundred fifty anterior-posterior radiographs of the pelvis of patients who were due to undergo THA were reviewed with standard magnification. The pathology in all the hips studied was osteoarthritis. Patients with inflammatory arthritides and osteoarthritis secondary to dysplasia were excluded, because they tend to have a wide degree of individual variations.
A line was placed along the long axis of the shaft of femur. This was done by plotting 3 pairs of points along the shaft of the femur.
Results
In our study, we found that the center of the femoral head was between 9 mm above the tip of the trochanter to 24 mm below the level of the trochanter.
We found that in 82% of cases (123 hips), the center of the femoral head lies below the level of the tip of the greater trochanter. In 4% (6 hips), the center was at level of the tip of the trochanter, and in 14% (21 hips), the center of the femoral head was above the level of the trochanter.
Discussion
Limb length discrepancy after THA remains a common cause of patient dissatisfaction. A review of the literature reveals 2 distinct types of limb lengthening. In the first scenario, the previously shortened limb has been corrected by the arthroplasty to a normal level and equal to the contralateral limb. In the second type, the limb was overcorrected and as a result was longer than the contralateral unaffected limb.
Our study shows that assessing the limb length by aligning the tip of the greater
References (5)
Anatomy of the femur, Gray's Anatomy online version
- et al.
Limb length discrepancy and related problems following total hip replacement
Clin Orthop
(1978)
Cited by (19)
Simple guidelines for evaluating intraoperative alignment after the reduction of intertrochanteric fractures
2021, Asian Journal of SurgeryReliability of relation between greater trochanter and center of rotation of femoral head in Indian population
2020, Journal of Clinical Orthopaedics and TraumaCitation Excerpt :There are few previous studies concerning this relationship in other populations which are summarized in Table 1. Our results are comparable to those of Dhinsa BS et al.,8 Memon AR et al.,10 Panichkul P et al.11 and Antapur P et al.12; those studies were based on the populations from United Kingdom, Ireland, and Thailand. However, the results are markedly different from those of Theivendran K et al.9 and Unnanuntana A et al.3 which studied populations from the United Kingdom and the USA, respectively.
Intraoperative assessment of reduction quality during nail fixation of intertrochanteric fractures
2020, InjuryCitation Excerpt :Haidukewych reported that the relationship between the greater trochanter and femoral head can be used to assess the varus/valgus and that the greater trochanter horizontal line can achieve the most optimal result when crossing the center of the femoral head [21]. Antapur et al. argued against the use of the greater trochanter tip as a guide for restoration of the femoral head center [28]. Baumgaertner et al. evaluated reduction quality, including the alignment and displacement of main fragments, based on two postoperative radiographic criteria.
Effect of surgical and natural menopause on proximal femur morphometry in obese women
2020, Annals of AnatomyCitation Excerpt :The other factors that are investigated for femur are BMI, body composition, obesity, menopausal status, BMD, osteoporosis, genetics, variation, hip fractures, bilateral asymmetry, anthropometry, preoperative planning according to caput femoris morphology (Sugano et al., 1999), proximal hip replacement and total hip subluxation (Kirchengast et al., 2001; Petit et al., 2005). Many studies have been conducted that showed the relation between hip joint surgical techniques and proximal femur parameters (Antapur and Prakash, 2006; Byström et al., 2003). When previous researchers were evaluating the femur parameters, either they made use of radiography, computed tomography, or dual-energy X-ray absorptiometry (DXA) imaging techniques or they directly investigated the dry bone.
Femoral Head Size is Correlated With Head Position in Very Elderly Patients
2017, Journal of ArthroplastyThe Femoral Head Center Shifts in a Mediocaudal Direction During Aging
2017, Journal of ArthroplastyCitation Excerpt :Third, the rule of thumb that the FHC is located at the level of tip of the GT does neither apply on the normal-aged THA population nor on the very elderly population and should, therefore, be seen as a common misconception. Although several authors reported this finding, the present study is the first assessing this relationship in 3 dimensions on a very elderly population [36,37,46,47]. As a consequence, none of the previous studies were able to reveal that in elderly females aged 80 years and older the FHC is on average 12.2 mm caudal to the tip of the GT, as reported in this study.
No benefits or funds were received in support of the study.