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. 2020 Nov;14(3):143-150.
doi: 10.5704/MOJ.2011.022.

Morphology of Proximal Femur in South-West Coast of India

S U Kamath  1 , S Agarwal  2 , J Austine  3
Affiliations

Morphology of Proximal Femur in South-West Coast of India

S U Kamath et al. Malays Orthop J. 2020 Nov.

Abstract

Introduction: With a higher proportion of young individuals undergoing uncemented hip arthroplasty, a close match in the dimension of the proximal femur and the implanted prosthesis is paramount. This is a study to gain insight into geographical variation in proximal femur morphology to determine the reference values to design uncemented femoral stems for a south Indian population, and also the effect of ageing and gender on the proximal femur morphology.

Materials and methods: The study comprised of two groups. For the first group, 50 unpaired dry femur bones were obtained from adult human cadavers; and the second group was a clinical group of 50 adult patients. Standardised radiographic techniques were used to measure the extra-cortical and intra-cortical morphometric parameters. Based on these, dimensionless ratios were calculated to express the shape of the proximal femur. The data were expressed in terms of mean and standard deviation and a comparison made with other studies.

Results: A significant difference was noted across various population subsets within the Indian subcontinent and also in comparison to the Western population, suggestive of regional variation. The measurements made in cadaveric bone differed significantly from those in live patients, especially the femoral head diameter and extra-cortical and intra-cortical width. Femoral offset, head height and diameter were significantly less in females.

Conclusion: The south Indian population needs customised implants with an increase in neck shaft angle and a decrease in intra-cortical and extra-cortical width for press fit in hip arthroplasty. The variation between the two sexes must also be accounted for during prosthesis design.

Keywords: arthroplasty; hip; morphometry; proximal femur; south Indian.

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Figures

Fig. 1:
Fig. 1:
For the AP view the patient was positioned supine on the table with the knees flexed over the edge and the lower portion of the legs perpendicular to the floor.
Fig. 2:
Fig. 2:
The lateral radiograph were obtained by flexing the index knee, with both the knee and ankle being horizontal to the floor and touching the table top.
Fig. 3:
Fig. 3:
Standard periosteal (extra-cortical) and endosteal (intra-cortical) dimensions in the antero-posterior view.
Fig. 4:
Fig. 4:
Standard periosteal (extra-cortical) and endosteal (intra-cortical) dimensions in the lateral view.
Fig. 5:
Fig. 5:
Canal flare index for Group 1.
Fig. 6:
Fig. 6:
Canal flare index for Group 2.
See this image and copyright information in PMC

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