Abstract
Purpose The femoral anterior bow is an important factor in matching a femoral implant to a femur. However, its morphology in the Chinese population has rarely been reported. In this study, a three-dimensional measurement approach was adopted to provide accurate data. The aim was to supply a reference for designing a long-stemmed femoral prosthesis that is more suitable for Chinese people. Methods Computed tomography data were collected from both lower limbs of 96 normal volunteers and reconstructed into a three-dimensional model using Mimics software. The parameters of the femoral anterior bow were measured using medical image analysis software. Statistical analysis was conducted using independent-samples and paired-samples t-tests with SPSS software. Results All the indexes showed significant sexual difference (P < 0.05). The minimum cross-sectional area of the femoral medullary cavity was larger in men (10.77 ± 1.53 mm) than in women (9.79 ± 1.27 mm). The distance from the position of the maximum curvature to the lower edge of the lesser trochanter was also larger in men (60.93 ± 5.81 mm) than in women (56.31 ± 2.80 mm). However, the curvature of the femoral medullary cavity centerline was larger in women (883.57 ± 249.74 mm) than in men (958.79 ± 266.61 mm). The femoral anterior bow morphological indexes of Chinese subjects were different from the published data for other populations. There were no significant differences between left and right femoral anterior bows in either sex (P > 0.05). Conclusion The three-dimensional measurement approach adopted in this study is more convenient and accurate than previous conventional methods, with high repeatability. The morphological indexes of the femoral anterior bow in this research suggest that population characteristics should be taken into account. This study will provide references for the design of long-stemmed femoral prostheses in the Chinese population.
Highlights
With the aging population and the popularization of artificial hip joints, periprosthetic fractures and the femoral anterior bow have gradually gained attention
The minimum cross-section of the femoral medullary cavity was regarded as an approximate circle, and the minimum diameter (MD) was used as the measurement index
The MD was normally distributed in the entire cohort, as well as in subgroups of men and women
Summary
With the aging population and the popularization of artificial hip joints, periprosthetic fractures and the femoral anterior bow have gradually gained attention. Owing to their high incidence, difficult treatment, various complications, and poor functional follow-up effects [1,2,3,4], periprosthetic fractures have become an urgent and important subject in the field of joint reconstruction. According to Moazen et al [5, 6], revision with a long-stemmed femoral prosthesis is the most effective way to solve the problem of periprosthetic fractures. The femoral anterior bow is one of the crucial factors that cause mismatch between the prosthesis and the femur [8]. The curvature and position of the anterior bow can differ
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