Head In Indian Population Research Articles

Association of Thrombophilic Factors in Pathogenesis of Osteonecrosis of Femoral Head in Indian Population.

Role of heritable blood clotting disorders, both thrombophilias and hypofibrinolysis in causing avascular necrosis (AVN) of femoral head have been studied in regions like Europe and U.S.A. This study was done to investigate the role of heritable thrombophilias in ethnic Indian population. A case control study of 150 patients (100 cases and 50 age and sex matched controls) of Indian Ethnicity with clinico-radiographically documented idiopathic AVNof femoral head was done after ethics committee approval. DNA was extracted from the blood and PCR analysis was used to study heritable thrombophilic gene mutation (G1691A Factor V Leiden). Enzyme-linked immunosorbent assay (ELISA)-based assays, were utilized to measure antigen levels of protein C, antithrombin III levels and protein S. Nine cases out of 100 showed deficiency of Protein C (9%) while no control showed deficiency of Protein C (p value: 0.028-significant, Odds ratio: 9.791) Ten cases showed deficiency of Protein S (10%) in study population as compared to one case (2%) in control population (p value: 0.038-significant, Odds ratio: 5.44). ATIII deficiency was more prevalent in control group i.e. 22% compared to 11% in study group. Factor V mutation was present in 3% cases as compared to one (2%) in control group. (p value is 0.393-not significant). Difference in thrombophilic mutations in various populations indicates possible effect of ethnicity on genetic profile in the development of AVN. This risk stratification will enable in near future early diagnosis and possible role of antithrombotics in disease prevention.

Reliability of relation between greater trochanter and center of rotation of femoral head in Indian population

PurposeAccurate limb length restoration forms an important aspect of reconstructive surgeries around the hip joint. Among the various intraoperative methods for accurate limb length restoration, the relation between the greater trochanter and the center of the femoral head has been conventionally used owing to its simplicity and replicability. The current study aims to study the normal relation between the greater trochanter and the center of rotation of the femoral head, its population-based variation and its gender-based and contralateral differences in the Indian population. MethodsStandard anteroposterior radiographs of normal hip joints with the proximal femur, performed over a one year period were studied. A software-based analysis was conducted to measure the difference between the levels of the greater trochanteric tip and the center of the femoral head along the longitudinal axis of the femur. The measurements among the male and female cases and the contralateral sides were compared. ResultsThe greater trochanteric tip lies at a higher level than the center of rotation of the femoral head by a mean difference of 9.20 ± 5.30 mm. No significant differences were observed among male and female groups and between the contralateral hip joints. Intraobserver and Interobserver reliability were high. ConclusionsThe tip of the greater trochanter and the center of the femoral head do not lie at the same level. This differential relation should be considered during the reconstructive surgeries around the hip joint to prevent an inadvertent limb length discrepancy. Considering the wide interindividual variations, this difference cannot be generalized for all the patients and restoring it to the contralateral normal hip would be more appropriate.