Abstract
Introduction: The Femoral angle of anteversion (FAA) is responsible for the medial and anterior direction of the femoral neck and therefore the femoral head towards the acetabulum. The aim of this study was to determine the difference in FAA between male and female samples, the correlation between the FAA and biomechanically relevant parameters and to provide a review of relevant clinical features related to FAA.
 Methods: We included 100 human dry femora and analyzed FAA, Angle of Inclination (AI), Femoral Head Diameter (FHD), Femoral Biomechanical Length (FBL) and Linear Condylar Parameters (Epicondylar Breadth Width (EBW), Lateral Condyle Depth and Medial Condyle Depth). The measurements were made using a goniometer, sliding calipers and pieces of colored string.
 Results: Mean FAA values were 9.84±7.97° and 8.72±8.23° for the male and female samples, respectively (p<0.05). FAA and AI in both male and female correlated negatively (-0.076), while there was a positive correlation between FAA and FHD (0.069), FAA and FBL (0.072), FAA and EBW (0.029), while the correlation was negative between FAA and LCD (-0.072), FAA and MCD (-0.063).
 Conclusion: The difference in FAA between male and female femora was found to be significant. This finding may help better understanding such as hip impingement, total hip arthroplasty failure, and design of femoral endoprosthesis parts.
Highlights
The femoral angle of anteversion (FAA) is responsible for the medial and anterior direction of femoral neck and, the femoral head toward the acetabulum
The angles around the proximal femur determine the two different coaptation forces that determine the static morphology of the joint space, no convincing correlation was found leading to the conclusion that FAA and angle of inclination (AI) together with the femoral head diameter (FHD) and femoral biomechanical length (FBL) biomechanically linked do not affect each other morphology
Cerebral palsy gait with hip flexion, adduction, and inner rotation induces larger resultant forces and vertical forces on contact and reduces horizontal forces seemingly resulting in a larger AI and FAA, resulting in aberrant proximal femoral morphology [20]
Summary
The femoral angle of anteversion (FAA) is responsible for the medial and anterior direction of femoral neck and, the femoral head toward the acetabulum. The axis of the acetabulum is pointed inferiorly, lateraly, and anteriorly at the same time leaving a portion of relatively round femoral head outside the acetabulum [1,2] Such relationships provided us with stable and unstable positions of the hip, with abduction, internal rotation, and extension being the stable position due to the better congruence between the bodies of the diarthrodial joint [1,6]. The angles around the proximal femur determine the two different coaptation forces that determine the static morphology of the joint space [6] These findings are relative to other morphologic and, biomechanical characteristics, such as ligament tension, muscle volume, and even negative atmospheric pressure [1,2,3]. New and comprehensive databases should be made and updated regularly
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