Three Dimensional Morphometry of Proximal Femur to Design Best-Fit Femoral Stem for Indonesian Population

Abstract

SUMMARY:To design custom-made prosthesis in a certain population, the morphometry needs to be measured. The results of this study were expected to provide basic data to design the ideal size of the total hip arthoplasty prosthesis for Indonesian population. This was an anthropometric study conducted on sex matched 100 healthy Indonesian mongoloid race subjects based on Computer Tomographic (CT) imaging on the proximal femur. The parameters being used in this study were Femoral Head Offset (FHO), Femoral Head Position (FHP), Femoral Head Diameter (FHD), Neck-Shaft Angle (NSA), Anteroposterior Width (APW) and Mediolateral Width at 3 different locations, and Canal Flare Index (CFI). This study showed that Indonesian has smaller proximal femur morphometry as compared to Western population. The mean value of all parameters in male were larger than female. Moreover, FHO and FHP showed significant difference among male and female indicating the location of male femoral head center lies superiorly as compared to female. The dimension of femoral canal was found to be mediolaterally oval, 1.43, 1.28, and 1,34, respectively, in 3 different cutting (20 mm above and 40 mm below lesser trochanter, and isthmus). CFI of Indonesian was classified to be stovepipe femoral canal (2.99) that is the suggestion to use cemented femoral stem. This study showed that Indonesian proximal femur dimension has smaller build compared with Western counterpart. The proposed dimensions can be used as the basic data to design the ideal size of the femoral stem for Indonesian population.

Computed tomography image analysis for Indonesian total hip arthroplasty designs

“…Figure 2 shows the three types are 20 mm above the lesser trochanter, 20 mm below the lesser trochanter, and 40 mm below the lesser trochanter. Figure 3 exhibits the APW and MLW for all three types in the right and left femurs [9]. APW1 and MLW1 for right femur are in Figure 3(a) and left femur are in Figure 3(b).…”

“…6, December 2022: 6123-6131 6124 are used to define the best measurement for implant design, including hip and knee [7], [8]. Particularly in the Indonesian case, a previous study has succeeded measuring the three-dimensional (3D) morphometry of proximal femur to design the best-fit femoral stem for the Indonesian population [9]. However, in that work, it only focused on giving the proposed dimension of proximal femur component with no hip implant design result for the Indonesian data.…”

“…THA is also used for people who suffer from a fracture of the neck femur, congenital abnormalities, tumor, joint damage, and other hip joint diseases [13]. However, the companies that produce the hip prosthesis of hip implants currently only use the proximal femur parameter of western society to reference the dimensions [9]. According to the world population review (WPR), the countries that are included in the western community category (WCC) are countries in the continent of Europe, America, and Australia [14].…”

“…According to the world population review (WPR), the countries that are included in the western community category (WCC) are countries in the continent of Europe, America, and Australia [14]. Research reveals that the size of the proximal femur in Indonesian society is smaller than in western civilization after conducting a comparison experiment of the proximal femur size using multinational data [9]. Femoral morphology and size are different between men and women [15].…”

“…This work aims to design a customized hip implant based on femoral proximal Indonesian female morphometry measurement using the latest correlated literacy [9]. In 2019, Tuong [16] summarized from several previous works that femur geometrical parameters of the Vietnamese population are different from Asian people, those are Thai, Malay, Indian, and Japanese.…”