Gender differences in 3D morphology and bony impingement of human hips

Nakahara, Ichirō; Takao, Masaki; Sakai, Takashi; Nishii, Takashi; Yoshikawa, Hideki; Sugano, Nobuhiko

doi:10.1002/jor.21265

Cited by 143 publications

(135 citation statements)

References 27 publications

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“…Many studies have investigated the associations between sex and hip anatomy (Table 5) [5,9,17,29,37,46,52] and between the femoral and acetabular parameters measured in this study (Table 6) [1-3, 9, 14, 24, 31, 39, 46, 50, 52, 54]. Our findings agree with most of this literature but do conflict with two studies [2,54] that found no association between femoral and acetabular version (Table 6).…”

Section: Discussionsupporting

confidence: 78%

“…For example, symptomatic dysplasia and excessive femoral anteversion are more common in females [18,20,35,49,54]. In several series of patients with FAI, women with symptomatic impingement had smaller cam deformities [17,20,24,37] but could present with worse preoperative scores for pain and function than men [23]. The associations between these various anatomic factors and how often they occur in a painful hip are unclear but if unaddressed at the time of surgery might explain failed hip preservation surgery.…”

Section: Introductionmentioning

confidence: 99%

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Two or More Impingement and/or Instability Deformities Are Often Present in Patients With Hip Pain

Tibor¹,

Liebert

Sutter

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Damage to the hip can occur due to impingement or instability caused by anatomic factors such as femoral and acetabular version, neck-shaft angle, alpha angle, and lateral center-edge angle (CEA). The associations between these anatomic factors and how often they occur in a painful hip are unclear but if unaddressed might explain failed hip preservation surgery. Questions/purposes We determined (1) the influence of sex on the expression of impingement-related or instability-related factors, (2) the associations among these factors, and (3) how often both impingement and/or instability factors occur in the same hip.Methods We retrospectively reviewed a cohort of 170 hips (145 patients) undergoing MR arthrography of the hip for any reason. We excluded 58 hips with high-grade dysplasia, Perthes' sequelae, previous surgery, or incomplete radiographic information, leaving 112 hips (96 patients). We measured femoral version and alpha angles on MR arthrograms. Acetabular anteversion, lateral CEA, and neck-shaft angle were measured on pelvic radiographs. Results We observed a correlation between sex and alpha angle. Weak or no correlations were observed between the other five parameters. In 66% of hips, two or more (of five) impingement parameters, and in 51% of hips, two or more (of five) instability parameters were found. Conclusions Patients with hip pain frequently have several anatomic factors potentially contributing to chondrolabral damage. To address pathologic hip loading due to impingement and/or instability, all of the anatomic influences should be known. As we found no associations between anatomic factors, we recommend an individualized assessment of each painful hip. Level of Evidence Level III, prognostic study. See Instructions for Authors for a complete description of levels of evidence.

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Section: Discussionsupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Two or More Impingement and/or Instability Deformities Are Often Present in Patients With Hip Pain

Tibor¹,

Liebert

Sutter

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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“…Recently, there has been a growing interest in 3D-CT as a research tool for the study of bone and joint anatomy and kinematics [1][2][3][4][5]. The resolution of CT is half the voxel size of CT scan [6,7].…”

Section: Introductionmentioning

confidence: 99%

Accuracy and Reliability of Length Measurements on Three-Dimensional Computed Tomography Using Open-Source OsiriX Software

et al. 2012

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There is a growing interest in three-dimensional computed tomography (3D-CT) as a research tool for the study of bone, joint anatomy, and kinematics. However, when CT data are processed and handled manually using image processing programs to yield 3D image and coordinate value, systematic and random errors should be validated. We evaluated the accuracy and reliability of length measurement on CT with OsiriX software. 3D-CT scans were made of 14 frozen pig knees with five transosseous holes in the metaphyseal portion of femur. The lengths between tunnel orifices were measured using Mitutoyo Digimatic digital calipers to establish the gold standard, and with the OsiriX program in 3D multi-planar reformatting mode for comparison. All measurements were recorded by a principal (replicate 1, trial 1) and a secondary observer (replicate 2, trial 1) and were repeated once by each observer (trial 2). The mean differences between OsiriX and real measurements were less than 0.1 mm in both replicates, and maximum differences were less than 0.3 mm. There were no significant differences between the replicates and real measurements (p00.544 and 0.622 for replicates 1 and 2, respectively). The intraclass correlation coefficients (ICC) were very high between trials and between replicates (ICC0 0.998 and 0.999, respectively). For kinematic analysis of the knees, length measurements on 3D-CT using OsiriX program can be used as alternatives to real measurements with less than 0.3-mm accuracy and very high reliability.

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“…It was assumed that the half of the femoral head included in the fluoroscopic imaging volume would not affect registration accuracy. We considered the location 3 cm above the acetabular roof to be a proper location centered on the ilium, because the diameter of the femoral head ranged from approximately 3.5 cm to 5.5 cm [12,13]. To assess the effect of the femur on CT-3D fluoroscopic matching of the pelvis, we selected the acetabular fossa as the imaging center, since the corresponding fluoroscopic imaging volume included the largest area of the proximal femur compared to that for the other two imaging centers.…”

Section: Discussionmentioning

confidence: 99%

“…Four markers were fixed to the peripheral region of the pelvis, one to each of the following sites: the anterior superior iliac spine (5), pubic tubercle (6), sciatic notch (7), and ischial tuberosity (8). Four markers were fixed to the femoral head and neck, one at each of the following locations: the superior (9), anterior (10), and inferior head-neck junctions (11), and the anterior cortex of the femoral neck (12). Finally, four markers were fixed to the proximal femur, one to each of the following sites: the tip of the great trochanter (13), the base of the lesser trochanter (14), and the anterior (15) and lateral sides of the femoral shaft (16).…”

Section: Methodsmentioning

confidence: 99%

Application of a CT-3D fluoroscopy matching navigation system to the pelvic and femoral regions

Takao

Nishii

Sakai

et al. 2012

Computer Aided Surgery

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Objective: The aim of this study was to find the proper location of the fluoroscopic imaging center in order to apply a CT-based 3D fluoroscopy matching navigation system in the pelvic and femoral regions. Materials and methods: To simulate surgeries around the hip joint, a dry human pelvis and femur were used. A total of 16 fiducial markers, each consisting of a metal ball 1.5 mm in diameter, were fixed to the pelvis and femur. For the pelvis, the pubic symphysis, the acetabular fossa, and a site on the ilium 3 cm above the acetabular roof were selected as fluoroscopic imaging centers. For the proximal femur, the base of the femoral neck, the femoral shaft at the level of the lesser trochanter, and the inferior border of the great trochanter were selected as fluoroscopic imaging centers. Results: Target registration error (TRE) differed significantly among the selected fluoroscopic imaging centers. The best mean TRE for the pelvis was 0.8 mm (range: 0.2 to 1.6 mm) with the imaging center on the ilium (3 cm above the acetabular roof). The best mean TRE for the proximal femur was 1.1 mm (range: 0.2 to 2.0 mm) with the imaging center on the femoral shaft at the lesser trochanter level. Conclusion: Fluoroscopic imaging center location had a significant effect on the accuracy of the CT-based 3D fluoroscopy matching navigation system in the pelvic and femoral regions. The proper fluoroscopic imaging centers for CT-3D fluoroscopic matching were, for the pelvis, a site on the ilium 3 cm above the acetabular roof, and for the proximal femur, the femoral shaft at the level of the lesser trochanter.

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Gender differences in 3D morphology and bony impingement of human hips

Cited by 143 publications

References 27 publications

Two or More Impingement and/or Instability Deformities Are Often Present in Patients With Hip Pain

Two or More Impingement and/or Instability Deformities Are Often Present in Patients With Hip Pain

Accuracy and Reliability of Length Measurements on Three-Dimensional Computed Tomography Using Open-Source OsiriX Software

Application of a CT-3D fluoroscopy matching navigation system to the pelvic and femoral regions

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