ABSTRACT
Background: Leg length discrepancy following hip arthroplasty causes dissatisfaction to the patient; thus, preoperative planning and implant selection is critical. The purpose of this study was to measure the articular-trochanteric distance (ATD) and femoral neck length (FNL) in our population and compare them to those of 3 of the most used uncemented stems. Methods: In this cross-sectional study, 401 hip radiographs of healthy adults were collected between January and July 2022. The vertical ATD and FNL were measured. A linear regression model was used to identify the relationship between these measurements and age, sex, and height. A logistic regression model was used to assess the matching of native hips with the neck length of the stem. Results: Mean age was 60 years, and 74.56% were women. In 94.3% of hips, the ATD was negative, 3.73% neutral, and 2% positive. In our population, 0.25% of FNL were shorter than POLARSTEM (Smith & Nephew, UK), 10.72% shorter than MetaFix stem (Corin, UK), and 11.97% shorter than Corail stem (DePuy Synthes, USA). In the logistic regression analysis, matching for the POLARSTEM was associated with age but not with sex or height. Conversely, for MetaFix and Corail, stem matching was associated with sex and height. Conclusions: Anthropometric hip measurements vary among individuals, and variables such as age, sex, and height must be considered during preoperative planning and implant selection to avoid leg length discrepancy. Additional studies, including different implants, are required to guide surgeons in selecting a femoral stem that best matches the patient's native hip.
ABSTRACT
SUMMARY: Different populations have different genetic traits, and this causes various anatomical features to emerge. Orthopedic implants used in Turkey are generally of Western origin, and these implants are designed based on the anatomical features of Western populations. This study aimed to evaluate the compatibility of existing implants for the Turkish population by revealing the anatomical features of the proximal femurs of individuals from the Turkish population while also constituting a helpful source of data on newly developed implants. A total of 1920 proximal femurs of 960 patients were evaluated via images obtained by Computer Tomography. Twenty patients (10 females and 10 males) for each age within the age range of 18-65 years were included. Femoral head diameter, femoral neck width, femoral neck length, medullary canal width, and collodiaphyseal angle were measured. The right and left femoral head diameter was 46.46±3.84 mm, 46.50 ±3.85 mm respectively. The right and left femoral neck width was 30.63±3.4 mm, 30.85±3.29 mm respectively. The neck length was 94.62±8.33 mm for the right proximal femur, it was 94.75±8.19 mm for the left. The width of the medullary canal was 15.46±2.25 mm for the right proximal femur and 15.53±2.20 mm for the left. The right and left hips, the collodiaphyseal angles were 133.06±2.39° and 133.13±2.36°. Anatomical features of the proximal femur vary according to age, sex, and race. This study may be used as an important resource for the evaluation of patients' compatibility with existing implants and for the design of new implants.
Diferentes poblaciones tienen diferentes rasgos genéticos, y esto hace que surjan varias características anatómicas. Los implantes ortopédicos utilizados en Turquía son generalmente de origen occidental y estos implantes están diseñados en función de las características anatómicas de estas poblaciones. Este estudio tuvo como objetivo evaluar la compatibilidad de los implantes existentes para la población turca al revelar las características anatómicas de las epífisis proximales de fémures de individuos de la población turca y, al mismo tiempo, constituir una fuente útil de datos sobre implantes recientemente desarrollados. Se evaluaron un total de 1920 fémures proximales de 960 pacientes mediante imágenes obtenidas por tomografía computarizada. Se incluyeron veinte pacientes (10 mujeres y 10 hombres) para cada edad dentro del rango de edad de 18 a 65 años. Se midió el diámetro de la cabeza femoral, el ancho del cuello femoral, la longitud del cuello femoral, el ancho del canal medular y el ángulo colodiafisario. El diámetro de la cabeza femoral derecha e izquierda fue de 46,46 ± 3,84 mm, 46,50 ± 3,85 mm, respectivamente. La anchura del cuello femoral derecho e izquierdo fue de 30,63±3,4 mm, 30,85±3,29 mm, respectivamente. La longitud del cuello fue de 94,62±8,33 mm para el fémur derecho, fue de 94,75±8,19 mm, para el izquierdo. El ancho del canal medular fue de 15,46±2,25 mm para el fémur derecho y de 15,53±2,20 mm para el izquierdo. Las caderas derecha e izquierda, los ángulos colodiafisarios fueron 133,06±2,39° y 133,13±2,36°. Las características anatómicas de la epífisis proximal del fémur varían según la edad, el sexo y la raza. Este estudio puede utilizarse como un recurso importante para la evaluación de la compatibilidad de los pacientes con los implantes existentes y para el diseño de nuevos implantes.