No proportional relationship between shape and size of the femoral canal and the external proximal femur morphology in elderly patients

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-01-15 DOI:10.1016/j.jor.2025.01.018

Hidde D. Veldman , Ide C. Heyligers , Tim A.E.J. Boymans

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引用次数: 0

Abstract

Introduction

The proximal femur morphology changes with age, which may complicate the compatibility of contemporary cementless stem designs in very elderly patients. This study investigated the internal and external proximal femur morphology, correlated canal dimensions with external dimensions, and examined whether age-associated changes in the femoral canal and external morphology are related in subjects aged 80 years and older.

Methods

Three-dimensional models of human femora were reconstructed from computed tomographic (CT) scans of 90 very elderly subjects (mean 84 years, range 80–105 years). Morphological parameters describing the location of the femoral head center (FHC) (i.e. neck-shaft angle [NSA], mediolateral offset [ML-offset], and distance between lesser trochanter (LT) and FHC [LT-FHC]) and parameters describing the canal morphology (i.e. the cortices, canal dimensions, and canal flare index [CFI]) were measured. Regression and correlation analyses were performed in order to assess the relation between internal and external morphology.

Results

No significant associations regarding dimensions nor geometry between internal and external femur morphology could be detected. Canal dimensions were not able to predict the external dimensions more accurately than the deviation between the individual value and the mean value for the total cohort.

Conclusions

Based on these findings, proportional sizing of the cementless femoral component is not necessarily endorsed in very elderly patients, and age-associated changes of the femoral canal and external morphology do not appear to be related. However, further research is needed to evaluate the ability of contemporary non-modular cementless stems to anatomically reconstruct the proximal femur in very elderly patients specifically.

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.