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The Three-Dimensional Morphology of Femoral Medullary Cavity in the Developmental Dysplasia of the Hip

OBJECTIVE: This study aimed to assess the morphology of the femoral medullary canal in subjects with developmental dysplasia of the hip (DDH) with the intent of improving the design of femoral stems in total hip arthroplasty. METHODS: Computed tomography images of 56 DDH hips, which were classified...

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Autores principales: Zhang, Min, Liu, Bo-Lun, Qi, Xin-Zheng, Yang, Qing-Qing, Sun, Jing-Yang, Zheng, Qing-Yuan, Zhang, Guo-Qiang, Cheng, Cheng-Kung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8264541/
https://www.ncbi.nlm.nih.gov/pubmed/34249886
http://dx.doi.org/10.3389/fbioe.2021.684832
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author Zhang, Min
Liu, Bo-Lun
Qi, Xin-Zheng
Yang, Qing-Qing
Sun, Jing-Yang
Zheng, Qing-Yuan
Zhang, Guo-Qiang
Cheng, Cheng-Kung
author_facet Zhang, Min
Liu, Bo-Lun
Qi, Xin-Zheng
Yang, Qing-Qing
Sun, Jing-Yang
Zheng, Qing-Yuan
Zhang, Guo-Qiang
Cheng, Cheng-Kung
author_sort Zhang, Min
collection PubMed
description OBJECTIVE: This study aimed to assess the morphology of the femoral medullary canal in subjects with developmental dysplasia of the hip (DDH) with the intent of improving the design of femoral stems in total hip arthroplasty. METHODS: Computed tomography images of 56 DDH hips, which were classified into Crowe I to Crowe IV, and 30 normal hips were collected and used to reconstruct three-dimensional morphology of the femoral medullary cavity. Images of twenty-one cross sections were taken from 20 mm above the apex of the lesser trochanter to the isthmus. The morphology of femoral cavity was evaluated on each cross section for the longest canal diameter, the femoral medullary torsion angle (FMTA), and the femoral medullary roundness index (FMRI). RESULTS: The Crowe IV group displayed the narrowest medullary canal in the region superior to the end of the lesser trochanter, but then gradually aligned with the medullary diameter of the other groups down to the isthmus. The FMTA along the femoral cavity increased with the severity of DDH, but the rate of variation of FMTA along the femoral canal was consistent in the DDH groups. The DDH hips generally showed a larger FMRI than the normal hips, indicating more elliptical shapes. CONCLUSION: A femoral stem with a cone shape in the proximal femur and a cylindrical shape for the remainder down to the isthmus may benefit the subjects with severe DDH. This design could protect bone, recover excessive femoral anteversion and facilitate the implantation in the narrow medullary canal.
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spelling pubmed-82645412021-07-09 The Three-Dimensional Morphology of Femoral Medullary Cavity in the Developmental Dysplasia of the Hip Zhang, Min Liu, Bo-Lun Qi, Xin-Zheng Yang, Qing-Qing Sun, Jing-Yang Zheng, Qing-Yuan Zhang, Guo-Qiang Cheng, Cheng-Kung Front Bioeng Biotechnol Bioengineering and Biotechnology OBJECTIVE: This study aimed to assess the morphology of the femoral medullary canal in subjects with developmental dysplasia of the hip (DDH) with the intent of improving the design of femoral stems in total hip arthroplasty. METHODS: Computed tomography images of 56 DDH hips, which were classified into Crowe I to Crowe IV, and 30 normal hips were collected and used to reconstruct three-dimensional morphology of the femoral medullary cavity. Images of twenty-one cross sections were taken from 20 mm above the apex of the lesser trochanter to the isthmus. The morphology of femoral cavity was evaluated on each cross section for the longest canal diameter, the femoral medullary torsion angle (FMTA), and the femoral medullary roundness index (FMRI). RESULTS: The Crowe IV group displayed the narrowest medullary canal in the region superior to the end of the lesser trochanter, but then gradually aligned with the medullary diameter of the other groups down to the isthmus. The FMTA along the femoral cavity increased with the severity of DDH, but the rate of variation of FMTA along the femoral canal was consistent in the DDH groups. The DDH hips generally showed a larger FMRI than the normal hips, indicating more elliptical shapes. CONCLUSION: A femoral stem with a cone shape in the proximal femur and a cylindrical shape for the remainder down to the isthmus may benefit the subjects with severe DDH. This design could protect bone, recover excessive femoral anteversion and facilitate the implantation in the narrow medullary canal. Frontiers Media S.A. 2021-06-24 /pmc/articles/PMC8264541/ /pubmed/34249886 http://dx.doi.org/10.3389/fbioe.2021.684832 Text en Copyright © 2021 Zhang, Liu, Qi, Yang, Sun, Zheng, Zhang and Cheng. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Bioengineering and Biotechnology
Zhang, Min
Liu, Bo-Lun
Qi, Xin-Zheng
Yang, Qing-Qing
Sun, Jing-Yang
Zheng, Qing-Yuan
Zhang, Guo-Qiang
Cheng, Cheng-Kung
The Three-Dimensional Morphology of Femoral Medullary Cavity in the Developmental Dysplasia of the Hip
title The Three-Dimensional Morphology of Femoral Medullary Cavity in the Developmental Dysplasia of the Hip
title_full The Three-Dimensional Morphology of Femoral Medullary Cavity in the Developmental Dysplasia of the Hip
title_fullStr The Three-Dimensional Morphology of Femoral Medullary Cavity in the Developmental Dysplasia of the Hip
title_full_unstemmed The Three-Dimensional Morphology of Femoral Medullary Cavity in the Developmental Dysplasia of the Hip
title_short The Three-Dimensional Morphology of Femoral Medullary Cavity in the Developmental Dysplasia of the Hip
title_sort three-dimensional morphology of femoral medullary cavity in the developmental dysplasia of the hip
topic Bioengineering and Biotechnology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8264541/
https://www.ncbi.nlm.nih.gov/pubmed/34249886
http://dx.doi.org/10.3389/fbioe.2021.684832
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