Bone morphology of the proximal femoral canal: ethnicity related differences and the influence on cementless tapered wedge stem designs

Wuestemann, Thies; Hoare, Samuel Gordon; Petersik, Andreas; Hofstaetter, Bernhard; Fehily, Max; Matsubara, Masaaki; Markel, David C.

doi:10.1177/1120700019895458

Cited by 11 publications

(17 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…At present, the design concept of the cementless prosthetic stem is the internal and external press-t xation of the medullary cavity. Although the study of the 3D morphology of the medullary cavity using CT has gradually increased, most studies have focused on the medial and lateral morphology of the medullary cavity rather than the anterior-posterior diameter [5,21]. The present study found that the medial-lateral morphology of the medullary cavity of the proximal femur had the following characteristics.…”

Section: Discussionmentioning

confidence: 52%

“…The morphology of the proximal end of the femoral medullary cavity is in uenced by human ethnicity. One study found signi cant differences in medullary cavity morphology between Caucasian and Japanese and non-Japanese Asian women [5]; however, the femoral NSA was similar in all Asian races [5]. The proximal femoral medullary cavity of the present northern Chinese study population was similar to that described in a Caucasian population [24], but there were signi cant differences at the level of the lesser trochanteric line and distally, suggesting that the application of the same type of stem may cause distal implantation di culties for Asians, and that Asians may require a ner distal stem than Caucasians.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Ct Measurement of Proximal Femoral Medullary Cavity Morphology in Healthy Subjects From Northern China

Zhao

Chen²,

Tian

et al. 2020

Preprint

View full text Add to dashboard Cite

Background In total hip arthroplasty (THA), optimal stability and fixation is achieved via tight adaptation of the prosthesis to the bone. This study aimed to analyze the proximal femoral medullary cavity morphology of Chinese subjects on three-dimensional reconstructed imagery to explore the factors influencing these parameters. Methods CT was performed on 63 healthy subjects from northern China (94 hips; 31 men, 63 women). Three-dimensional CT reconstruction of the proximal femoral medullary cavity was performed using Mimics 22.0 software. The anatomical parameters related to THA were measured to examine the relationships between sex, age, and femoral length. These parameters were compared with previously published data. Results The internal and external coronal diameters of the femoral medullary cavity, and the anterior and posterior sagittal diameters had different contracting trends. There were correlations between the femoral length, femoral head diameter, and coronal diameter, and between the sagittal diameter and cross-sectional area of the medullary cavity. Age was negatively correlated with the CFI. Sex was correlated with the cross-sectional coronal/sagittal diameters, but not with the canal flare index. The proximal end of the medullary cavity was similar to that reported in Caucasians, but the Asian medullary cavity was narrower distal to the level of the lesser trochanteric line. Conclusion THA-related anatomy was affected by sex, age, and subpopulation. Compared with sex, age had a greater effect on the fit of the stem to the femoral canal. Each patient must be treated individually, as the anatomical structure varied between individuals.

show abstract

Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Ct Measurement of Proximal Femoral Medullary Cavity Morphology in Healthy Subjects From Northern China

Zhao

Chen²,

Tian

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…external press-t xation of the medullary cavity. Although the study of the 3D morphology of the medullary cavity using CT has gradually increased, most studies have focused on the medial and lateral morphology of the medullary cavity rather than the anterior-posterior diameter [5,21]. The present study found that the medial-lateral morphology of the medullary cavity of the proximal femur had the following characteristics.…”

Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

“…Currently, most THA prostheses are designed based on the parameters of the medullary cavity of the Caucasian population. However, the shape of the medullary cavity is signi cantly in uenced by ethnicity [5]. Most studies evaluating the morphology of the proximal femoral medullary cavity in Asians are based on two-dimensional studies [6,7], with less studies based on three-dimensional (3D) CT [8].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

CT Measurement of Proximal Femoral Medullary Cavity Morphology in Healthy Subjects from Northern China

Zhao

Cai

Zhang

et al. 2020

Preprint

View full text Add to dashboard Cite

Purpose: In total hip arthroplasty (THA), optimal stability and fixation is achieved via tight adaptation of the prosthesis to the bone. This study aimed to analyze the proximal femoral medullary cavity morphology of Chinese subjects on three-dimensional reconstructed imagery to explore the factors influencing these parameters.Methods: CT was performed on 63 healthy subjects from northern China (94 hips; 31 men, 63 women). Three-dimensional CT reconstruction of the proximal femoral medullary cavity was performed using Mimics 22.0 software. The anatomical parameters related to THA were measured to examine the relationships between sex, age, and femoral length. These parameters were compared with previously published data.Results: The internal and external coronal diameters of the femoral medullary cavity, and the anterior and posterior sagittal diameters had different contracting trends. There were correlations between the femoral length, femoral head diameter, and coronal diameter, and between the sagittal diameter and cross-sectional area of the medullary cavity. Age was negatively correlated with the CFI(canal flare index). Sex was correlated with the cross-sectional coronal/sagittal diameters, but not with the canal flare index. The proximal end of the medullary cavity was similar to that reported in Caucasians, but the Asian medullary cavity was narrower distal to the level of the lesser trochanteric line.Conclusions: THA-related anatomy was affected by sex, age, and subpopulation. Compared with sex, age had a greater effect on the fit of the stem to the femoral canal. Each patient must be treated individually, as the anatomical structure varied between individuals.

show abstract

A comparison between Asians and Caucasians in the dimensions of the femoral isthmus based on a 3D-CT analysis of 1189 adult femurs

Thiesen

Ntalos

Korthaus

et al. 2021

Eur J Trauma Emerg Surg

Self Cite

View full text Add to dashboard Cite

Introduction For successful intramedullary implant placement at the femur, such as nailing in unstable proximal femur fractures, the use of an implant that at least reaches or exceeds the femoral isthmus and yields sufficient thickness is recommended. A number of complications after intramedullary femoral nailing have been reported, particularly in Asians. To understand the anatomical features of the proximal femur and their ethnic differences, we aimed to accurately calculate the femoral isthmus dimensions and proximal distance of Asians and Caucasians. Methods In total, 1189 Asian and Caucasian segmented 3D CT data sets of femurs were analyzed. The individual femoral isthmus diameter was precisely computed to investigate whether gender, femur length, age, ethnicity or body mass index have an influence on isthmus diameters. Results The mean isthmus diameter of all femurs was 10.71 ± 2.2 mm. A significantly larger diameter was found in Asians when compared to Caucasians (p < 0.001). Age was a strong predictor of the isthmus diameter variability in females (p < 0.001, adjusted r2 = 0.299). With every year of life, the isthmus showed a widening of 0.08 mm in women. A Matched Pair Analysis of 150 female femurs showed a significant difference between isthmus diameter in Asian and Caucasian femurs (p = 0.05). In 50% of the cases the isthmus was found in a range of 2.4 cm between 16.9 and 19.3 cm distal to the tip of the greater trochanter. The female Asian femur differs from Caucasians as it is wider at the isthmus. Conclusions In absolute values, the proximal isthmus distance did not show much variation but is more proximal in Asians. The detailed data presented may be helpful in the development of future implant designs. The length and thickness of future standard implants may be considered based on the findings.

show abstract

Bone morphology of the proximal femoral canal: ethnicity related differences and the influence on cementless tapered wedge stem designs

Cited by 11 publications

References 27 publications

Ct Measurement of Proximal Femoral Medullary Cavity Morphology in Healthy Subjects From Northern China

Ct Measurement of Proximal Femoral Medullary Cavity Morphology in Healthy Subjects From Northern China

CT Measurement of Proximal Femoral Medullary Cavity Morphology in Healthy Subjects from Northern China

A comparison between Asians and Caucasians in the dimensions of the femoral isthmus based on a 3D-CT analysis of 1189 adult femurs

Contact Info

Product

Resources

About