Abstract
Background
Several anatomical studies regarding the value of hip rotation center (HRC) and femoral offset (FO) have been performed in Western populations. However, there are a few data on hip morphological values in the Chinese population based on CT scans. This study measured the values of the hip and pelvis, especially HRC and FO, in a Chinese population and compared them with the published values obtained from Western populations.
Patients and methods
One hundred patients (50 females and 50 males) were included in the present study, and 3D-CT reconstructions of the hip and pelvis were generated. The mean age was 51.4 ± 8.9 years and mean body mass index (BMI) was 23.5 ± 2.6 kg/m2. All the morphologic measurements were compared between genders and sides, and the relationships between different parameters were analyzed.
Results
The mean FO values were 38.4 ± 4.7 mm and 35.6 ± 4.4 mm for the males and females, respectively. A significant negative correlation was noted between FO and neck shaft angle (NSA) in both genders (r = − 0.262, P = 0.009 for the males, r = − 0.350, P ≤ 0.001 for the females). A significant positive correlation was found between horizontal distance (HD) and diameter of the femoral head (DFH) in both genders (r = 0.734, P ≤ 0.001 for the males, r = 0.658, P ≤ 0.001 for the females). A significant positive correlation was noted between HD and pelvic width (PW) in males (r = 0.455, P ≤ 0.001). A significant positive correlation was also noted between HD and pelvic height (PH) in males (r = 0.318, P ≤ 0.001). A significant positive correlation was observed between FO and pelvic cavity height (PCH) in males (r = 0.411, P ≤ 0.001), and a significant positive correlation was observed between VD and PCH in females (r = 0.497, P ≤ 0.001). The tip of the greater trochanter was, on average, 7.0 mm higher than the femoral head center. Relationships between DFH and pelvic morphometric parameters were also observed.
Conclusion
The present morphological data and the relationships between them can be applied to design better ethnic-specific THA prostheses and preoperative plans.
Similar content being viewed by others
References
Abel MF, Sutherland DH, Wenger DR et al (1994) Evaluation of CT scans and 3-D reformatted images for quantitative assessment of the hip. J Pediatr Orthop 14:48–53
Abolghasemian M, Samiezadeh S, Jafari D et al (2013) Displacement of the hip center of rotation after arthroplasty of Crowe III and IV dysplasia: a radiological and biomechanical study. J Arthroplasty 28:1031–1035
Asayama I, Chamnongkich S, Simpson KJ et al (2005) Reconstructed hip joint position and abductor muscle strength after total hip arthroplasty. J Arthroplasty 20:414–420
Blum MA, Ibrahim SA (2012) Race/ethnicity and use of elective joint replacement in the management of end-stage knee/hip osteoarthritis: a review of the literature. Clin Geriatr Med 28:521–532
Cassidy KA, Noticewala MS, Macaulay W et al (2012) Effect of femoral offset on pain and function after total hip arthroplasty. J Arthroplasty 27:1863–1869
Clement ND, Macdonald SP-PR D et al (2016) Total hip replacement: increasing femoral offset improves functional outcome. Arch Orthop Trauma Surg 136:1317–1323
Conn KS, Clarke MT, Hallett JP (2002) A simple guide to determine the magnification of radiographs and to improve the accuracy of preoperative templating. J Bone Jt Surg Br 84:269–272
Crowe JF, Mani VJ, Ranawat CS (1979) Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Jt Surg Am 61:15–23
Devane PA, Horne JG (1999) Assessment of polyethylene wear in total hip replacement. Clin Orthop Relat Res 369:59–72
Innmann MM, Maier MW, Streit MR et al (2018) Additive influence of hip offset and leg length reconstruction on postoperative improvement in clinical outcome after total hip arthroplasty. J Arthroplasty 33:156–161
Innmann MM, Spier K, Streit MR et al (2017) Comparative analysis of the reconstruction of individual hip anatomy using three different cementless stem designs in patients with primary hip osteoarthritis. J Arthroplasty 33:1126–1132
Ji HM, Won SH, Han J et al (2017) Does femoral offset recover and affect the functional outcome of patients with displaced femoral neck fracture following hemiarthroplasty? Injury 48:1170–1174
Kiyama T, Naito M, Shitama H et al (2009) Effect of superior placement of the hip center on abductor muscle strength in total hip arthroplasty. J Arthroplasty 24:240–245
Krishnan SP, Carrington RWJ, Mohiyaddin S et al (2006) Common misconceptions of normal hip joint relations on pelvic radiographs. J Arthroplasty 21:409–412
Kurtz WB, Ecker TM, Reichmann WM et al (2010) Factors affecting bony impingement in hip arthroplasty. J Arthroplasty 25:624–634
Larson AN, Rabenhorst B, Rocha ADL et al (2012) Limited intraobserver and interobserver reliability for the common measures of hip joint congruency used in dysplasia. Clin Orthop Relat Res 470:1414–1420
Lecerf G, Fessy MH, Philippot R et al (2009) Femoral offset: Anatomical concept, definition, assessment, implications for preoperative templating and hip arthroplasty. Orthop Traumatol Surg Res 95:210–219
Liebs TR, Nasser L, Herzberg W et al (2014) The influence of femoral offset on health-related quality of life after total hip replacement. Bone Jt J 96-B(1):36–42
Little NJ, Busch CA, Gallagher JA et al (2009) Acetabular polyethylene wear and acetabular inclination and femoral offset. Clin Orthop Relat Res 467:2895–2900
Ma H, Han Y, Yang Q et al (2014) Three-dimensional computed tomography reconstruction measurements of acetabulum in Chinese adults. Anat Rec (Hoboken) 297:643–649
Maratt JD, Esposito CI, Mclawhorn AS et al (2015) Pelvic tilt in patients undergoing total hip arthroplasty: when does it matter? J Arthroplasty 30:387–391
Mcgrory BJ, Morrey BF, Cahalan TD et al (1995) Effect of femoral offset on range of motion and abductor muscle strength after total hip arthroplasty. J Bone Jt Surg Br 77:865–869
Merle C, Waldstein W, Pegg E et al (2012) Femoral offset is underestimated on anteroposterior radiographs of the pelvis but accurately assessed on anteroposterior radiographs of the hip. J Bone Jt Surg Br 94:477–482
Mikhail MB, Vaswani AN, Aloia JF (1996) Racial differences in femoral dimensions and their relation to hip fracture. Osteoporos Int 6:22–24
Mineta K, Goto T, Wada K et al (2016) CT-based morphological assessment of the hip joint in Japanese patients: association with radiographic predictors of femoroacetabular impingement. Bone Jt J 98-B:1167–1174
Ng VY, Kean JR, Glassman AH (2013) Limb-length discrepancy after hip arthroplasty. J Bone Jt Surg Am 95:1426–1436
Noble PC, Alexander JW, Lindahl LJ et al (1988) The anatomic basis of femoral component design. Clin Orthop Relat Res 235:148–165
Pasquier G, Ducharne G, Ali ES et al (2010) Total hip arthroplasty offset measurement: Is C T scan the most accurate option? Orthop Traumatol Surg Res 96:367–375
Patel AB, Wagle RR, Usrey MM et al (2010) Guidelines for implant placement to minimize impingement during activities of daily living after total hip arthroplasty. J Arthroplasty 25:1275–1281
Pierchon F, Migaud H, Duquennoy A et al (1993) Radiologic evaluation of the rotation center of the hip. Rev Chir Orthop Reparatrice Appar Mot 79:281–284
Sakalkale DP, Sharkey PF, Eng K et al (2001) Effect of femoral component offset on polyethylene wear in total hip arthroplasty. Clin Orthop Relat Res 388:125–134
Sariali E, Mouttet A, Pasquier G et al (2009) Three-dimensional hip anatomy in osteoarthritis. Analysis of the femoral offset. J Arthroplasty 24:990–997
Takamatsu T, Shishido T, Takahashi Y et al (2015) Radiographic determination of hip rotation center and femoral offset in japanese adults: a preliminary investigation toward the preoperative implications in total hip arthroplasty. Biomed Res Int 2015:610763
Varghese B, Muthukumar N, Balasubramaniam M et al (2011) Reliability of measurements with digital radiographs—a myth. Acta Orthop Belg 77:622–625
Warden SJ, Hill KM, Ferira AJ et al (2013) Racial differences in cortical bone and their relationship to biochemical variables in Black and White children in the early stages of puberty. Osteoporos Int 24:1869–1879
Zhang Y, Jiang J, Wang C et al (2014) The ratio of femoral head diameter to pelvic height in the normal hips of a Chinese population. Eur J Orthop Surg Traumatol 24:947–951
Zhang YY, Liu PY, Lu Y et al (2010) Race and sex differences and contribution of height: a study on bone size in healthy Caucasians and Chinese. Am J Hum Biol 17:568–575
Acknowledgements
This work has received the financial support from the National Natural Science Foundation of China (81672184), Key Program of Science and Technique Development Foundation in Jiangsu Province (BE2015627), Research Project of Jiangsu Provincial Health Department (H201528), China Postdoctoral Science Foundation Funded Project (2016M591929, 2017T100408), and Jiangsu Provincial Medical Youth Talent (QNRC2016801).
Author information
Authors and Affiliations
Contributions
KJG and XZ: protocol development. LHY, XZ, and RL: data collection. ZYZ, JLT, and CWB: data analysis. LHY and FCZ: manuscript writing.
Corresponding authors
Ethics declarations
Conflict of interest
The author declares that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Yi, Lh., Li, R., Zhu, Zy. et al. Anatomical study based on 3D-CT image reconstruction of the hip rotation center and femoral offset in a Chinese population: preoperative implications in total hip arthroplasty. Surg Radiol Anat 41, 117–124 (2019). https://doi.org/10.1007/s00276-018-2143-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00276-018-2143-9