Department of Orthopedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, 211Eonju-ro, Gangnam-gu, Seoul, 06273, Korea.
Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
J Orthop Surg Res. 2024 Sep 28;19(1):590. doi: 10.1186/s13018-024-05084-1.
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).
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.
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 R values were 0.711 (ACA5), 0.677 (ACA10), 0.572 (ACA15), 0.493 (PCA5), 0.574 (PCA10), and 0.446 (PCA15).
Natural FA can be inferred from the anterior cortical angle (ACA) from femoral neck cutting plane observed during the THA procedure without preoperative images.
Retrospectively registered.
本研究旨在阐明全髋关节置换术（THA）过程中遇到的股骨近端骨结构的方向与术前股骨前倾角（FA）之间的关系。
共对 80 名参与者的全长下肢 CT 图像进行三维建模。在相对于小转子的 5、10 和 15mm 高度进行股骨颈切割。颈切割后，前外皮质和后外皮质与后髁线（PCL）形成的角度分别定义为前皮质角（ACA）和后皮质角（PCA）。使用 FA 作为因变量对其余测量值进行单变量线性回归分析。
参与者的平均年龄为 60.98±10.82 岁（男性 60.50±11.36 岁，女性 61.45±10.37 岁）（p=0.697）。女性的所有皮质角和 FA 均大于男性。按年龄组比较测量值，无统计学差异。以 FA 为因变量的单变量线性回归分析显示所有皮质角均有统计学意义。调整后的 R 值分别为 0.711（ACA5）、0.677（ACA10）、0.572（ACA15）、0.493（PCA5）、0.574（PCA10）和 0.446（PCA15）。
在 THA 过程中，可以从股骨颈切割平面观察到的前皮质角（ACA）推断出自然 FA，而无需术前图像。
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