The importance of radiological parameters of proximal femoral morphology in recovery management of patients with avascular necrosis undergoing hip arthroplasty

Abstract

Background and Objectives: Our study aimed to radiologically assess the morphology of the proximal femur in patients with avascular necrosis (AVN). We considered that the correct evalu-ation of the proximal femur morphology is essential and shows multiple clinical applications that can impact patient recovery and outcome. Materials and Methods: Our study included 177 pa-tients (85 male and 92 female) with AVN regardless of the degree. The patients were assessed by bilateral hip X-ray in the supine position. We selected the most common radiographic parame-ters to evaluate for all patients: cortical thickness index (CTI), canal flare index (CFI), cal-car-to-canal ratio (CCR), and morphological cortical index (MCI). Results: Average values for the parameters were: CTI = 0.5192 ± 0.07528, CFI= 3.5515 ± 0.5071, CCR = 0.4469 ± 0.05363 and MCI = 2.7572 ± 0.07704. We found no statistically significant differences between genders, except for CFI (p = 0.0325). Conclusions: The anatomical configuration of the proximal femur can play a major role in the process of planning the appropriate implant for total hip arthroplasty, as well as in the proper positioning of the implant during the surgical procedure. A thorough knowledge of the proximal femur morphology can be of great use to the orthopedic surgeon and may help de-crease perioperative complications.

Keywords

• radiology; morphometry
• anatomical variation
• avascular necrosis
• orthopedics
• arthroplasty
• rehabilitation