Kim Ju-Yeong, Kong Gyu-Min
Department of Orthopedic Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, 11 Samjeongja-ro, Seongsan-gu, Changwon 51472, Republic of Korea.
Department of Orthopedic Surgery, Inje University Haeundae Paik Hospital, 875 Haeun-daero, Haeundae-gu, Busan 48108, Republic of Korea.
Medicina (Kaunas). 2024 Nov 23;60(12):1930. doi: 10.3390/medicina60121930.
: The anterolateral bowing of the femur shows differences between races and has recently caused many clinical problems. Asians tend to have increased femoral bowing, but there is a lack of large-scale studies. We aim to identify the patterns of femoral bowing in the Korean population through comprehensive analysis and address its clinical implications. : We analyzed 550 femoral radiographs from Korean patients using three different views: anteroposterior, lateral, and 15-degree internal rotation. Initial univariate analysis examined age and gender differences, followed by multivariate analysis incorporating height and weight to understand their combined effects on femoral bowing. : The study included 229 (41.6%) males and 321 (58.4%) females, with a mean age of 62.53 years (SD = 21.93). Initial analysis showed greater femoral bowing in females than males by 2.72° ( < 0.001) in anteroposterior views. However, multivariate analysis revealed age to be the primary significant factor affecting femoral bowing across all viewing angles ( < 0.001), while gender effects became non-significant when controlling for other variables. The AP angle regression model explained 26% of the total variance, with each year increase in age associated with a 0.12-degree increase in bowing angle. : This study demonstrated that age is the primary factor influencing femoral bowing in the Korean population, with apparent gender differences potentially attributable to age distribution differences between groups. Anteroposterior radiographic imaging proved most suitable for assessing bowing angles. These findings provide important insights for surgical planning and implant selection, particularly in addressing potential mismatch issues in Asian populations.
股骨前外侧弓形弯曲在不同种族间存在差异，近来引发了诸多临床问题。亚洲人股骨弓形弯曲往往更明显，但缺乏大规模研究。我们旨在通过全面分析确定韩国人群股骨弓形弯曲的模式，并探讨其临床意义。
我们使用前后位、侧位和15度内旋位三种不同视角，分析了550例韩国患者的股骨X线片。最初的单因素分析检测年龄和性别差异，随后进行多因素分析，纳入身高和体重以了解它们对股骨弓形弯曲的综合影响。
该研究纳入229例（41.6%）男性和321例（58.4%）女性，平均年龄62.53岁（标准差=21.93）。初步分析显示，在前后位视角下，女性的股骨弓形弯曲比男性大2.72°（P<0.001）。然而，多因素分析表明，在所有视角下，年龄是影响股骨弓形弯曲的主要显著因素（P<0.001），而在控制其他变量后，性别影响变得不显著。前后位角度回归模型解释了总方差的26%，年龄每增加一岁，弯曲角度增加0.12度。
本研究表明，年龄是影响韩国人群股骨弓形弯曲的主要因素，明显的性别差异可能归因于组间年龄分布差异。前后位X线成像被证明最适合评估弯曲角度。这些发现为手术规划和植入物选择提供了重要见解，尤其是在解决亚洲人群潜在的不匹配问题方面。
