Femoral Neck Anteversion: Which Distal Femur Landmark Matters?
Background: Femoral neck anteversion has traditionally been measured by the angle between the distal femur posterior condylar axis (PCA) and a line drawn through the center of the femoral head and neck. While less common, the transepicondylar axis (TEA) has also been used to reference femoral neck a...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-04-01
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| Series: | Arthroplasty Today |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344124000037 |
| _version_ | 1797237971210993664 |
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| author | Elizabeth Davis, MD Drake G. LeBrun, MD, MPH Thomas McCarthy, PhD Geoffrey H. Westrich, MD |
| author_facet | Elizabeth Davis, MD Drake G. LeBrun, MD, MPH Thomas McCarthy, PhD Geoffrey H. Westrich, MD |
| author_sort | Elizabeth Davis, MD |
| collection | DOAJ |
| description | Background: Femoral neck anteversion has traditionally been measured by the angle between the distal femur posterior condylar axis (PCA) and a line drawn through the center of the femoral head and neck. While less common, the transepicondylar axis (TEA) has also been used to reference femoral neck anteversion. The purpose of this study was to compare femoral neck version of the PCA vs the TEA using computerized tomography (CT). Methods: A total of 1507 femoral CTs were included. Precise bony landmarks were established: lateral epicondyle, medial epicondyle, posteromedial condyle, posterolateral condyle, center of the femoral neck, and center of the femoral head. Femoral version was calculated between the head and neck axis and either the PCA or TEA. Differences between sex and ethnicity were evaluated. Results: The mean femoral anteversion was 12.7° ± 9.1° based on the PCA and 11.5° ± 7.9° based on the TEA (mean difference 1.2° ± 1.9°, P < .001). Males were less anteverted than females (9.8° ± 7.6° vs 13.5° ± 7.8°, P < .001). African Americans had less anteversion than other groups (8.1° ± 9.2° vs 11.5° ± 7.8°, P = .04), while Asians were more anteverted than other groups (12.1° ± 9.0° vs 11.2° ± 7.3°, P = .04). These values were referenced on the TEA. Conclusions: In this series of over 1500 femoral CT scans, the mean difference between anteversion measurements referencing the PCA and TEA was 1.2°. Native femoral version varied widely between gender and ethnic groups. Extreme femoral version, defined as <0° or >30°, was present in 11.8% of patients referencing the PCA. |
| first_indexed | 2024-03-07T19:09:22Z |
| format | Article |
| id | doaj.art-70ab60bf31b341f399cdee89f429e8fd |
| institution | Directory Open Access Journal |
| issn | 2352-3441 |
| language | English |
| last_indexed | 2024-04-24T17:28:13Z |
| publishDate | 2024-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj.art-70ab60bf31b341f399cdee89f429e8fd2024-03-28T06:38:09ZengElsevierArthroplasty Today2352-34412024-04-0126101318Femoral Neck Anteversion: Which Distal Femur Landmark Matters?Elizabeth Davis, MD0Drake G. LeBrun, MD, MPH1Thomas McCarthy, PhD2Geoffrey H. Westrich, MD3Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, NY, USAAdult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, NY, USA; Corresponding author. Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, 535 E 70th Street, 3rd Floor, New York, NY 10065, USA. Tel.: +1 469 358 5445.Stryker, Mahwah, NJ, USAAdult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, NY, USABackground: Femoral neck anteversion has traditionally been measured by the angle between the distal femur posterior condylar axis (PCA) and a line drawn through the center of the femoral head and neck. While less common, the transepicondylar axis (TEA) has also been used to reference femoral neck anteversion. The purpose of this study was to compare femoral neck version of the PCA vs the TEA using computerized tomography (CT). Methods: A total of 1507 femoral CTs were included. Precise bony landmarks were established: lateral epicondyle, medial epicondyle, posteromedial condyle, posterolateral condyle, center of the femoral neck, and center of the femoral head. Femoral version was calculated between the head and neck axis and either the PCA or TEA. Differences between sex and ethnicity were evaluated. Results: The mean femoral anteversion was 12.7° ± 9.1° based on the PCA and 11.5° ± 7.9° based on the TEA (mean difference 1.2° ± 1.9°, P < .001). Males were less anteverted than females (9.8° ± 7.6° vs 13.5° ± 7.8°, P < .001). African Americans had less anteversion than other groups (8.1° ± 9.2° vs 11.5° ± 7.8°, P = .04), while Asians were more anteverted than other groups (12.1° ± 9.0° vs 11.2° ± 7.3°, P = .04). These values were referenced on the TEA. Conclusions: In this series of over 1500 femoral CT scans, the mean difference between anteversion measurements referencing the PCA and TEA was 1.2°. Native femoral version varied widely between gender and ethnic groups. Extreme femoral version, defined as <0° or >30°, was present in 11.8% of patients referencing the PCA.http://www.sciencedirect.com/science/article/pii/S2352344124000037AnteversionComputerized tomographyPosterior condylar axisTransepicondylar axisTotal hip arthroplasty |
| spellingShingle | Elizabeth Davis, MD Drake G. LeBrun, MD, MPH Thomas McCarthy, PhD Geoffrey H. Westrich, MD Femoral Neck Anteversion: Which Distal Femur Landmark Matters? Arthroplasty Today Anteversion Computerized tomography Posterior condylar axis Transepicondylar axis Total hip arthroplasty |
| title | Femoral Neck Anteversion: Which Distal Femur Landmark Matters? |
| title_full | Femoral Neck Anteversion: Which Distal Femur Landmark Matters? |
| title_fullStr | Femoral Neck Anteversion: Which Distal Femur Landmark Matters? |
| title_full_unstemmed | Femoral Neck Anteversion: Which Distal Femur Landmark Matters? |
| title_short | Femoral Neck Anteversion: Which Distal Femur Landmark Matters? |
| title_sort | femoral neck anteversion which distal femur landmark matters |
| topic | Anteversion Computerized tomography Posterior condylar axis Transepicondylar axis Total hip arthroplasty |
| url | http://www.sciencedirect.com/science/article/pii/S2352344124000037 |
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