Definition of a Novel Proximal Femur Classification in the Sagittal Plane According to the Femur Morphometric Analysis.


Journal

The Journal of arthroplasty
ISSN: 1532-8406
Titre abrégé: J Arthroplasty
Pays: United States
ID NLM: 8703515

Informations de publication

Date de publication:
07 2019
Historique:
received: 20 01 2019
revised: 26 02 2019
accepted: 02 03 2019
pubmed: 8 4 2019
medline: 17 6 2020
entrez: 8 4 2019
Statut: ppublish

Résumé

Studies on prosthesis positioning and implant design in total hip arthroplasty (THA) have generally focused on the anatomy of the proximal femur in the coronal plane. The aim of this study was to investigate the proximal femur morphology in the sagittal plane to provide better positioning of the femoral component in THA and contribute to the determination of proximal femur morphology through possible outcomes that can be shown also by considering the sagittal plane in the selection and design of the femoral component. Computerized tomography scans were obtained from 270 femoral bones belonging to adult skeletons, followed by 3D reconstruction using Leonardo Dr/Dsa Va30a software (Siemens, Erlangen, Germany) and measurements. Canal widths were measured in the coronal and sagittal planes at the lesser trochanter (LT) level, at 20 millimeters proximal to the LT(LT+20) and at various levels distal to the lesser trochanter in 25 mm jumps up to 200 mm from the lesser trochanter. The average width was wider at the level of the lesser trochanter and all points distal to it in the sagittal plane compared to the coronal plane except LT-200 mm. At each levels from LT-25 to LT-175, the differences were statistically significant (P < .05). The ratio of the femoral width at the lesser trochanter level to the width 50 mm distal to the LT was stated as the most prevalent one, and a novel classification in the sagittal plane was developed in accordance with these findings. A novel and simple classification in the sagittal plane was developed based on the findings of this study, and this classification may improve the accuracy, validity, and reliability of femoral stem fixation in total hip arthroplasty.

Sections du résumé

BACKGROUND
Studies on prosthesis positioning and implant design in total hip arthroplasty (THA) have generally focused on the anatomy of the proximal femur in the coronal plane. The aim of this study was to investigate the proximal femur morphology in the sagittal plane to provide better positioning of the femoral component in THA and contribute to the determination of proximal femur morphology through possible outcomes that can be shown also by considering the sagittal plane in the selection and design of the femoral component.
METHODS
Computerized tomography scans were obtained from 270 femoral bones belonging to adult skeletons, followed by 3D reconstruction using Leonardo Dr/Dsa Va30a software (Siemens, Erlangen, Germany) and measurements. Canal widths were measured in the coronal and sagittal planes at the lesser trochanter (LT) level, at 20 millimeters proximal to the LT(LT+20) and at various levels distal to the lesser trochanter in 25 mm jumps up to 200 mm from the lesser trochanter.
RESULTS
The average width was wider at the level of the lesser trochanter and all points distal to it in the sagittal plane compared to the coronal plane except LT-200 mm. At each levels from LT-25 to LT-175, the differences were statistically significant (P < .05). The ratio of the femoral width at the lesser trochanter level to the width 50 mm distal to the LT was stated as the most prevalent one, and a novel classification in the sagittal plane was developed in accordance with these findings.
CONCLUSION
A novel and simple classification in the sagittal plane was developed based on the findings of this study, and this classification may improve the accuracy, validity, and reliability of femoral stem fixation in total hip arthroplasty.

Identifiants

pubmed: 30954411
pii: S0883-5403(19)30228-1
doi: 10.1016/j.arth.2019.03.005
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1502-1508

Informations de copyright

Copyright © 2019 Elsevier Inc. All rights reserved.

Auteurs

Murat Bozkurt (M)

Department of Orthopedics and Traumatology, Ankara Yildirim Beyazit University, Ankara, Turkey.

Safa Gursoy (S)

Department of Orthopedics and Traumatology, Ankara Yildirim Beyazit University, Ankara, Turkey.

Noam Shohat (N)

The Rothman Institute at Thomas Jefferson University, Philadelphia, PA; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Mehmet Emin Simsek (ME)

Department of Orthopedics and Traumatology, Yenimahalle Training and Research Hospital, Ankara, Turkey.

Mustafa Akkaya (M)

Department of Orthopedics and Traumatology, Ankara Yildirim Beyazit University, Ankara, Turkey.

Javad Parvizi (J)

The Rothman Institute at Thomas Jefferson University, Philadelphia, PA.

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