Functional and Anatomic Orientation of the Femoral Head

Overview

Journal Clin Orthop Relat Res

Publisher Wolters Kluwer

Specialty Orthopedics

Date 2011 Jan 8

PMID 21213086

Citations 13

Authors

David Wright

Cari Whyne

Michael Hardisty

Hans J Kreder

Omri Lubovsky

Affiliations

Soon will be listed here.

Abstract

Background: Femoral neck geometry directly affects load transmission through the hip. Orientations may be described anatomically or using functional definitions that consider load transmission.

Questions/purposes: This study introduces and applies a new method for characterizing functional femoral orientation based on the distribution of subchondral bone density in the femoral head and compares it with orientation measures generated via established anatomic landmark-based methods. Both orientation methods then are used to characterize side-to-side symmetry of orientation and differences between men and women within the population.

Patients And Methods: A retrospective review of CT imaging data from 28 patients was performed. Anatomic orientation was determined using established two-dimensional and three-dimensional landmarking methods. Subchondral bone density maps were generated and used to define a density-weighted surface normal vector. Orientation angles generated by the three methods were compared, with side-to-side symmetry and differences between genders also investigated.

Results: The three methods measured substantially different angles for anteversion and neck-shaft angle. Weak correlations were found between anatomic and functional orientation measures for neck-shaft angle only.

Conclusions: Neck-shaft angles calculated using the functional orientation method corresponded well with previous in vivo loading data. An absence of strong correlation between functional and anatomic measures reinforces the concept that bone geometry is not solely responsible for determining loading of the femoral head.

Level Of Evidence: Level II, Diagnostic Studies--Investigating a Diagnostic Test. See the Guidelines for Authors for a complete description of levels of evidence.

Citing Articles

Femoral neck shaft angle measurement on plain radiography: is standing or supine radiograph a reliable template for the contralateral femur?.

Haddad B, Hamdan M, Al Nawaiseh M, Aldowekat O, Alshrouf M, Karam A BMC Musculoskelet Disord. 2022; 23(1):1092.

PMID: 36514028 PMC: 9749307. DOI: 10.1186/s12891-022-06071-5.

Comparing two different automatic methods to measure femoral neck-shaft angle based on PointNet++ network.

Li Z, Yang J, Li X, Wang K, Han J, Yang P Sci Rep. 2022; 12(1):12437.

PMID: 35858999 PMC: 9300576. DOI: 10.1038/s41598-022-16695-1.

Automatic Femoral Deformity Analysis Based on the Constrained Local Models and Hough Forest.

Duan L, Sun H, Liu D, Tan Y, Guo Y, Chen J J Digit Imaging. 2022; 35(2):162-172.

PMID: 35013828 PMC: 8921433. DOI: 10.1007/s10278-021-00550-2.

Femoral neck strain prediction during level walking using a combined musculoskeletal and finite element model approach.

Altai Z, Montefiori E, van Veen B, Paggiosi M, McCloskey E, Viceconti M PLoS One. 2021; 16(2):e0245121.

PMID: 33524024 PMC: 7850486. DOI: 10.1371/journal.pone.0245121.

Avoiding malalignment in proximal femur fractures treated with newer generation cephalomedullary nails: Some technical tips.

Kumar A, Mittal S, Jain A, Trikha V J Clin Orthop Trauma. 2019; 10(Suppl 1):S242-S246.

PMID: 31695290 PMC: 6823690. DOI: 10.1016/j.jcot.2018.11.008.

References

Johnston J, Masri B, Wilson D . Computed tomography topographic mapping of subchondral density (CT-TOMASD) in osteoarthritic and normal knees: methodological development and preliminary findings. Osteoarthritis Cartilage. 2009; 17(10):1319-26. DOI: 10.1016/j.joca.2009.04.013. View

Dalstra M, Huiskes R . Load transfer across the pelvic bone. J Biomech. 1995; 28(6):715-24. DOI: 10.1016/0021-9290(94)00125-n. View

Sugano N, Noble P, Kamaric E . A comparison of alternative methods of measuring femoral anteversion. J Comput Assist Tomogr. 1998; 22(4):610-4. DOI: 10.1097/00004728-199807000-00019. View

Maruyama M, Feinberg J, Capello W, DAntonio J . The Frank Stinchfield Award: Morphologic features of the acetabulum and femur: anteversion angle and implant positioning. Clin Orthop Relat Res. 2002; (393):52-65. View

Park T, Park S, Kim J, Kim I, Kim S . Measurement of femoral neck anteversion in 3D. Part 1: 3D imaging method. Med Biol Eng Comput. 2001; 38(6):603-9. DOI: 10.1007/BF02344864. View

Hoaglund F, LOW W . Anatomy of the femoral neck and head, with comparative data from Caucasians and Hong Kong Chinese. Clin Orthop Relat Res. 1980; (152):10-6. View

Dewire P, Simkin P . Subchondral plate thickness reflects tensile stress in the primate acetabulum. J Orthop Res. 1996; 14(5):838-41. DOI: 10.1002/jor.1100140524. View

Lee Y, Oh S, Seon J, Song E, Yoon T . 3D femoral neck anteversion measurements based on the posterior femoral plane in ORTHODOC system. Med Biol Eng Comput. 2006; 44(10):895-906. DOI: 10.1007/s11517-006-0104-7. View

Cheng X, Lowet G, Boonen S, Nicholson P, Brys P, Nijs J . Assessment of the strength of proximal femur in vitro: relationship to femoral bone mineral density and femoral geometry. Bone. 1997; 20(3):213-8. DOI: 10.1016/s8756-3282(96)00383-3. View

10.

Ito M, Wakao N, Hida T, Matsui Y, Abe Y, Aoyagi K . Analysis of hip geometry by clinical CT for the assessment of hip fracture risk in elderly Japanese women. Bone. 2009; 46(2):453-7. DOI: 10.1016/j.bone.2009.08.059. View

11.

Bergmann G, Deuretzbacher G, Heller M, Graichen F, Rohlmann A, Strauss J . Hip contact forces and gait patterns from routine activities. J Biomech. 2001; 34(7):859-71. DOI: 10.1016/s0021-9290(01)00040-9. View

12.

Toogood P, Skalak A, Cooperman D . Proximal femoral anatomy in the normal human population. Clin Orthop Relat Res. 2008; 467(4):876-85. PMC: 2650061. DOI: 10.1007/s11999-008-0473-3. View

13.

Tonnis D, Heinecke A . Acetabular and femoral anteversion: relationship with osteoarthritis of the hip. J Bone Joint Surg Am. 1999; 81(12):1747-70. DOI: 10.2106/00004623-199912000-00014. View

14.

Muller-Gerbl M, Putz R, Hodapp N, Schulte E, Wimmer B . Computed tomography-osteoabsorptiometry for assessing the density distribution of subchondral bone as a measure of long-term mechanical adaptation in individual joints. Skeletal Radiol. 1989; 18(7):507-12. DOI: 10.1007/BF00351749. View

15.

Grynpas M, Alpert B, Katz I, Lieberman I, Pritzker K . Subchondral bone in osteoarthritis. Calcif Tissue Int. 1991; 49(1):20-6. DOI: 10.1007/BF02555898. View

16.

Wedge J, MUNKACSI I, Loback D . Anteversion of the femur and idiopathic osteoarthrosis of the hip. J Bone Joint Surg Am. 1989; 71(7):1040-3. View

17.

Lubovsky O, Wright D, Hardisty M, Kiss A, Kreder H, Whyne C . Importance of the dome and posterior wall as evidenced by bone density mapping in the acetabulum. Clin Biomech (Bristol). 2010; 26(3):262-6. DOI: 10.1016/j.clinbiomech.2010.11.002. View