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. 2019 Jan;41(1):117-124. doi: 10.1007/s00276-018-2143-9. Epub 2018 Nov 28.

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.

Keywords: Anatomy; Image reconstruction; Pelvis; Total hip arthroplasty.

MeSH terms

  • Adult
  • Aged
  • Arthroplasty, Replacement, Hip*
  • China
  • Female
  • Femur Head / anatomy & histology*
  • Femur Head / diagnostic imaging*
  • Hip Joint / anatomy & histology*
  • Hip Joint / diagnostic imaging*
  • Humans
  • Imaging, Three-Dimensional*
  • Male
  • Middle Aged
  • Rotation
  • Tomography, X-Ray Computed*