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Intraoperative estimation of natural femoral anteversion from proximal femoral osseous orientation during total hip arthroplasty

Authors
 Woo-Suk Lee  ;  Soon-Phil Yoon  ;  Ju Hyung Lee  ;  Kwan Kyu Park  ;  Kyoung Tak Kang  ;  Byung-Woo Cho 
Citation
 JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH, Vol.19(1) : 590, 2024-09 
Journal Title
JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH
Issue Date
2024-09
MeSH
Aged ; Arthroplasty, Replacement, Hip* / methods ; Bone Anteversion / diagnostic imaging ; Bone Anteversion / etiology ; Bone Anteversion / prevention & control ; Female ; Femur Neck / diagnostic imaging ; Femur Neck / surgery ; Femur* / diagnostic imaging ; Femur* / surgery ; Humans ; Imaging, Three-Dimensional / methods ; Male ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed*
Keywords
Intraoperative osseous orientation ; Natural femoral anteversion ; Total hip arthroplasty
Abstract
Background: The purpose of this study was to elucidate the relationship between the orientation of the osseous structure of the proximal femur encountered during total hip arthroplasty (THA) and preoperative femoral anteversion (FA). Methods: Three-dimensional models were constructed using full-length lower extremity computed tomography images from a total of 80 participants. Femoral neck cutting was performed at heights of 5, 10, and 15 mm relative to the lesser trochanter. Following neck cutting, the angles formed by the anterior outer cortex and posterior outer cortex with the posterior condylar line (PCL) were defined as the anterior cortical angle (ACA) and posterior cortical angle (PCA), respectively. Univariate linear regression analysis was conducted using the remaining measurements with FA as the dependent variable. Results: The mean age of the participants was 60.98 ± 10.82 years (males, 60.50 ± 11.36 years; females, 61.45 ± 10.37 years) (p = 0.697). All cortical angles and FA were larger in women compared to those in men. When comparing measurements by age groups, no statistically significant differences were observed. Univariate linear regression analysis with FA as the dependent variable showed statistical significance for all cortical angles. The adjusted R2 values were 0.711 (ACA5), 0.677 (ACA10), 0.572 (ACA15), 0.493 (PCA5), 0.574 (PCA10), and 0.446 (PCA15). Conclusion: Natural FA can be inferred from the anterior cortical angle (ACA) from femoral neck cutting plane observed during the THA procedure without preoperative images. Trial registration: Retrospectively registered.
Files in This Item:
T202406384.pdf Download
DOI
10.1186/s13018-024-05084-1
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Park, Kwan Kyu(박관규) ORCID logo https://orcid.org/0000-0003-0514-3257
Lee, Woo Suk(이우석) ORCID logo https://orcid.org/0000-0002-0798-1660
Cho, Byung Woo(조병우) ORCID logo https://orcid.org/0000-0002-7472-4103
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/201029
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