Side-to-side variation in normal femoral morphology: 3D CT analysis of 122 femurs

Abstract Background The contralateral femur is often used as reference for reconstruction in unilateral hip joint pathology. The objective of this study was to quantify the side-to-side variation in proximal femur. We hypothesized that significant side-to-side differences exist between left and righ...

Full description

Saved in:
Bibliographic Details
Published in:Orthopaedics & traumatology, surgery & research surgery & research, 2016-02, Vol.102 (1), p.91-97
Main Authors: Dimitriou, D, Tsai, T.-Y, Yue, B, Rubash, H.E, Kwon, Y.-M, Li, G
Format: Article
Language:English
Subjects:
Adult
Anteversion
Asymmetry
Computer Simulation
Female
Femur - anatomy & histology
Femur - diagnostic imaging
Geommetric morphometrics
Healthy Volunteers
Hip Joint - anatomy & histology
Hip Joint - diagnostic imaging
Hip joint center
Humans
Male
Middle Aged
Multidetector Computed Tomography
Offset
Orthopedics
Proximal femur
Retrospective Studies
Surgery
Tomography, Spiral Computed
Tomography, X-Ray Computed
Total hip arthroplasty
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Background The contralateral femur is often used as reference for reconstruction in unilateral hip joint pathology. The objective of this study was to quantify the side-to-side variation in proximal femur. We hypothesized that significant side-to-side differences exist between left and right femur with implications for preoperative planning and leg length discrepancy following hip arthroplasty. Materials and methods CT-based 3D femoral models were reconstructed for 122 paired femurs in 61 young healthy subjects (46.9 ± 6.8 years) with no history of hip pathology. Side-to-side differences of several femoral morphologic parameters, including femoral head diameter, femoral anteversion, horizontal offset and femoral head center location, were compared and correlated with demographic factors using multiple linear regression. Results Significant side-to-side differences ( P < 0.01) were found in femoral anteversion (4.3 ± 3.8°; range: 0.2° to 17.3°), horizontal offset (2.5 ± 2.1 mm; range: 0.1 to 10.3 mm), and femoral head center location (7.1 ± 3.8 mm; range: 0.5 to 19.4 mm). The difference in femoral anteversion was strongly correlated with the difference in neck diameter (R2 = 0.79), whereas the difference in horizontal femoral offset was highly correlated with the head diameter difference (R2 = 0.72). Femoral head center difference was correlated with the femoral anteversion, horizontal offset and neck-shaft-angle difference (R2 = 0.82). Discussion Relying on the anatomic landmarks of the contralateral femur during hip arthroplasty may not necessarily result in restoration of native anatomy and leg-length. Knowledge of the baseline side-to-side asymmetry could provide a range of error that would be tolerable following hip reconstruction. Level of evidence Level IV. Type of study Retrospective observational study.
ISSN:1877-0568
1877-0568
DOI:10.1016/j.otsr.2015.11.004