The anatomical shape of the proximal femur correlates with the distal femur anatomy.
Classification
Distal
Femur
Proximal
Journal
Archives of orthopaedic and trauma surgery
ISSN: 1434-3916
Titre abrégé: Arch Orthop Trauma Surg
Pays: Germany
ID NLM: 9011043
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
received:
31
05
2022
accepted:
28
02
2023
medline:
31
7
2023
pubmed:
20
3
2023
entrez:
19
3
2023
Statut:
ppublish
Résumé
In the case of stemmed implants for lower limb joint arthroplasty procedures, implant stability and survivorship generally rely on the strength of fixation in the medullary canal regardless of whether the procedure is primary or revision surgery. This study aimed to investigate the relationship between the proximal (Dorr classification) and distal (Citak classification) femoral canal geometry classification systems. A total of 200 patients who received standing long leg radiographs (hip to ankle) at our institution were identified using our institutional electronic radiology database. Patients were recruited into 4 groups. There were 100 male and 100 female patients with each of those being split into 50 right-sided and 50 left-sided long-leg standing anteroposterior (AP) radiographs. Two independent, blinded observers reviewed each radiograph on two separate occasions, with a minimum of a one-week interval between sittings to review each respective radiograph. No statistically significant correlation was found between demographic data and clinical measurements. A statistically significant correlation was found between the patient's age and BMI results and Citak and Dorr measurements. There was excellent inter-observer and intra-observer agreement for the Citak and Dorr Classifications. The mean Cronbach's α coefficient was 0.96 (range 0.93-0.98) for the Citak Classification and 0.95 (range 0.83-0.97) for the Dorr Classification. There was also an excellent intra-observer agreement with 95% average pairwise per cent agreement for the Citak Classification and 95% average pairwise per cent agreement for the Dorr classification. A statistically significant positive correlation was found between Dorr Calcar Isthmus and Citak Ratio (p < 0.05). In this study, the Dorr and Citak classifications are put into relation to each other for the first time. The morphology of the femur was investigated in its entirety and it was shown that there was a positive correlation between the anatomical shape of the proximal and distal medullary canals.
Identifiants
pubmed: 36934328
doi: 10.1007/s00402-023-04833-x
pii: 10.1007/s00402-023-04833-x
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
5221-5227Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Bozkurt M, Gursoy S, Shohat N, Simsek ME, Akkaya M, Parvizi J (2019) Definition of a novel proximal femur classification in the sagittal plane according to the femur morphometric analysis. J Arthroplasty 34(7):1502–1508
doi: 10.1016/j.arth.2019.03.005
pubmed: 30954411
Christie M, Brinson MF (2005) Proximal/distal mismatch: type A and C femurs. Orthopedics 28(9 Suppl):s1033-1036
pubmed: 16190030
Citak M, Levent A, Suero EM, Rademacher K, Busch SM, Gehrke T (2022) A novel radiological classification system of the distal femur. Arch Orthop Trauma Surg 142(2):315–322
doi: 10.1007/s00402-021-03828-w
pubmed: 33638676
Cristofolini L, Erani P, Bialoblocka-Juszczyk E et al (2010) Effect of undersizing on the long-term stability of the Exeter hip stem: a comparative in vitro study. Clin Biomech (Bristol, Avon) 25(9):899–908
doi: 10.1016/j.clinbiomech.2010.07.003
pubmed: 20659780
de Boer FA, Sariali E (2017) Comparison of anatomic vs. straight femoral stem design in total hip replacement—femoral canal fill in vivo. Hip Int 27(3):241–244
doi: 10.5301/hipint.5000439
pubmed: 27886361
Dorr LD, Faugere MC, Mackel AM, Gruen TA, Bognar B, Malluche HH (1993) Structural and cellular assessment of bone quality of proximal femur. Bone 14(3):231–242
doi: 10.1016/8756-3282(93)90146-2
pubmed: 8363862
Engh CA, Glassman AH, Suthers KE (1990) The case for porous-coated hip implants. The femoral side. Clin Orthop Relat Res 261:63–81
doi: 10.1097/00003086-199012000-00009
Fottner A, Woiczinski M, Kistler M et al (2017) Influence of undersized cementless hip stems on primary stability and strain distribution. Arch Orthop Trauma Surg 137(10):1435–1441
doi: 10.1007/s00402-017-2784-x
pubmed: 28865042
Griza S, Gomes LS, Cervieri A, Strohaecker TR (2015) Migration and strains induced by different designs of force-closed stems for THA. Rev Bras Ortop 50(6):686–693
doi: 10.1016/j.rbo.2014.10.003
pubmed: 27218081
pmcid: 4867916
Husmann O, Rubin PJ, Leyvraz PF, de Roguin B, Argenson JN (1997) Three-dimensional morphology of the proximal femur. J Arthroplasty 12(4):444–450
doi: 10.1016/S0883-5403(97)90201-1
pubmed: 9195321
Inoue D, Kabata T, Maeda T et al (2016) The correlation between clinical radiological outcome and contact state of implant and femur using three-dimensional templating software in cementless total hip arthroplasty. Eur J Orthop Surg Traumatol 26(6):591–598
doi: 10.1007/s00590-016-1796-5
pubmed: 27334622
Issa K, Stroh AD, Mont MA, Bonutti PM (2014) Effect of bone type on clinical and radiographic outcomes of a proximally-coated cementless stem in primary total hip arthroplasties. J Orthop Res 32(9):1214–1220
doi: 10.1002/jor.22648
pubmed: 24838949
Kim YH, Kim VE (1993) Uncemented porous-coated anatomic total hip replacement. Results at six years in a consecutive series. J Bone Jt Surg Br 75(1):6–13
doi: 10.1302/0301-620X.75B1.8421036
Laine HJ, Pajamaki KJ, Moilanen T, Lehto MU (2001) The femoral canal fill of two different cementless stem designs. The accuracy of radiographs compared to computed tomographic scanning. Int Orthop 25(4):209–213
doi: 10.1007/s002640100245
pubmed: 11561492
pmcid: 3620821
Lee SH, Shih HN, Chang CH, Lu TW, Chang YH, Lin YC (2020) Influence of extension stem length and diameter on clinical and radiographic outcomes of revision total knee arthroplasty. BMC Musculoskelet Disord 21(1):15
doi: 10.1186/s12891-019-3030-1
pubmed: 31914984
pmcid: 6950863
Levent A, Suero EM, Gehrke T, Bakhtiari IG, Citak M (2020) Risk factors for aseptic loosening in complex revision total knee arthroplasty using rotating hinge implants. Int Orthop 45(1):125–132
doi: 10.1007/s00264-020-04878-2
pubmed: 33188603
Levent A, Suero EM, Gehrke T, Citak M (2021) Risk factors for aseptic loosening after total knee arthroplasty with a rotating-hinge implant. J Bone Jt Surg 103(6):517–523
doi: 10.2106/JBJS.20.00788
Levent A, Suero EM, Gehrke T, Citak M (2021) Risk factors for aseptic loosening after total knee arthroplasty with a rotating-hinge implant: a case-control study. J Bone JT Surg Am 103(6):517–523
doi: 10.2106/JBJS.20.00788
Magill P, Hill J, O’Brien S, Stevenson M, Machenaud A, Beverland D (2020) Observed effect of femoral component undersizing and a collarless design in the development of radiolucent lines in cementless total hip arthroplasty. Arthroplast Today 6(1):99–103
doi: 10.1016/j.artd.2019.11.009
pubmed: 32211484
pmcid: 7083744
Manocchio AG Jr, Berend KR, Morris MJ, Adams JB, Lombardi AV Jr (2017) Early experience with a tapered titanium porous plasma sprayed stem with updated design. Surg Technol Int 31:231–235
pubmed: 29313319
Meijerink HJ, van Loon CJ, de Waal Malefijt MC, van Kampen A, Verdonschot N (2010) A sliding stem in revision total knee arthroplasty provides stability and reduces stress shielding. Acta Orthop 81(3):337–343
doi: 10.3109/17453674.2010.483991
pubmed: 20450422
pmcid: 2876836
Morgan-Jones R, Oussedik SI, Graichen H, Haddad FS (2015) Zonal fixation in revision total knee arthroplasty. Bone Jt J 97-b(2):147–149
doi: 10.1302/0301-620X.97B2.34144
Morwood MP, Guss AD, Law JI, Pelt CE (2020) Metaphyseal stem extension improves tibial stability in cementless total knee arthroplasty. J Arthroplasty 35(10):3031–3037
doi: 10.1016/j.arth.2020.05.068
pubmed: 32600812
Nakaya R, Takao M, Hamada H, Sakai T, Sugano N (2019) Reproducibility of the Dorr classification and its quantitative indices on plain radiographs. Orthop Traumatol Surg Res 105(1):17–21
doi: 10.1016/j.otsr.2018.11.008
pubmed: 30594598
Narayanan R, Elbuluk AM, Chen KK, Eftekhary N, Zuckerman JD, Deshmukh AJ (2020) Does femoral morphology and stem alignment influence outcomes of cementless total hip arthroplasty with proximally coated double-tapered titanium stems? Hip Int 31(3):354–361
doi: 10.1177/1120700019891702
pubmed: 31912748
Pitto RP, Hayward A, Walker C, Shim VB (2010) Femoral bone density changes after total hip arthroplasty with uncemented taper-design stem: a five year follow-up study. Int Orthop 34(6):783–787
doi: 10.1007/s00264-009-0884-0
pubmed: 19946775
Ratner B (2009) The correlation coefficient: Its values range between +1/−1, or do they? J Target Meas Anal Mark 17(2):139–142
doi: 10.1057/jt.2009.5
Rayan F, Dodd M, Haddad FS (2008) European validation of the Vancouver classification of periprosthetic proximal femoral fractures. J Bone Jt Surg Br 90(12):1576–1579
doi: 10.1302/0301-620X.90B12.20681
van Loon CJ, Kyriazopoulos A, Verdonschot N, de Waal Malefijt MC, Huiskes R, Buma P (2000) The role of femoral stem extension in total knee arthroplasty. Clin Orthop Relat Res 378:282–289
doi: 10.1097/00003086-200009000-00039
Walsh CP, Han S, Canham CD, Gonzalez JL, Noble P, Incavo SJ (2019) Total knee arthroplasty in the osteoporotic tibia: a biomechanical evaluation of the role of stem extensions and cementing techniques. J Am Acad Orthop Surg 27(10):370–374
doi: 10.5435/JAAOS-D-17-00736
pubmed: 31085949
Weber M, Lechler P, von Kunow F et al (2015) The validity of a novel radiological method for measuring femoral stem version on anteroposterior radiographs of the hip after total hip arthroplasty. Bone Jt J 97-B(3):306–311
doi: 10.1302/0301-620X.97B3.34618
Wilkerson J, Fernando ND (2020) Classifications in Brief: The Dorr Classification of Femoral Bone. Clin Orthop Relat Res 478(8):1939–1944
doi: 10.1097/CORR.0000000000001295
pubmed: 32732579
pmcid: 7371079