ESTIMATION OF MEAN VALUES OF FEMORAL ANTEVERSION, ACETABULAR ANTEVERSION, COMBINED ANTEVERSION AND ANTEVERSION RATIO IN NORMAL INDIAN POPULATION: AN MRI BASED STUDY

Dr. Ashish Agrawal; Dr. Yashkumar B. Shihora

doi:10.53555/jptcp.v31i2.4334

Dr. Ashish Agrawal
Dr. Yashkumar B. Shihora

Keywords

Hip joint, femoral neck anteversion, acetabulum anteversion, combined anteversion angle, anteversion ratio

Abstract

Background: The purpose of this study to estimate mean values of femoral anteversion, acetabular anteversion, combined anteversion and anteversion ratio in normal Indian population.

Methods: It is a prospective study conducted between october 2019 to May 2023 in R.D.Gardi Medical College, Ujjain, M.P.188 normal Indian adults (376 hips), of which 96 were males and 92 were females, fulfilling the inclusion and exclusion criteria selected on a random basis were included in the study.

Results: The mean FA in our study was found to be 16.02⁰, with a mean value of 16.56⁰ on the right side and a mean value of 15.49⁰ on the left side. The mean AA in our study was found to be 16.11⁰, with a mean value of 17.05⁰ on the right side and a mean value of 15.18⁰ on the left side. The mean CA in our study was found to be 32.14⁰, with a mean value of 33.61⁰ on the right side and a mean value of 30.67⁰ on the left side. Mean anteversion ratio in the total population was found to be 1.11, with a mean of 1.07 on the right side while on the left side it was 1.16.

Conclusion: The correct estimation of FA, AA, CA and AR in a given population depends on the appropriate method along with a proper technique. MRI was found to be better and safer than CT scan, as oblique images of the femoral neck can be obtained without the use of ionizing radiation.

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References

1. Tonnis D, Heinecke A. Acetabular and femoral anteversion: relationship with osteoarthritis of the hip. J Bone Joint Surg Am 1999; 81:1747-70.
2. Reikeras O, Bjerkreim I, Kolbenstvedt A. Anteversion of the acetabulum in patients with idiopathic increased anteversion of the femoral neck. Acta Orthop Scand 1982; 53:847-52.
3. Reikeras O, Hoiseth A, Reigstad A, Fonstelien E. Femoral neck angles. Acta orthop. Scand 1982; 53:775-9.
4. McKibbin B. Anatomical factors in the stability of the hip joint in the newborn. J Bone Joint Surg Br 1970; 52:148-59.
5. Ruby L, Mital MA, Connor JO, Patel U. Anteversion of the femoral neck. J Bone Joint Surg Am 1979; 61:46-51.
6. Crane L. Femoral torsion and its relation to toeing-in and toeing-out. J Bone Joint Surg Am 1959; 41:421-8.
7. Dorr LD, Wan Z, Malik A, Dastane M. Combined anteversion technique for total hip arthroplasties. Clin OrthopRelat Res 2009; 467:119-27.
8. Dorr LD, Wan Z, Malik A, Dastane M, Zhu J. Comparison of surgeon estimation and computed tomographic measurement of femoral component anteversion in cementless Total Hip Arthroplasties. J Bone Joint Surg Am 2009; 91:2598-604.
9. Dorr LD. Hip Arthroplasty: minimal invasive techniques and computer navigation. Philadelphia: Saunders 2005.
10. Malik A, Maheshwari A, Dorr LD. Impingement with Total Hip Replacement. J Bone Joint Surg Am 2007; 89:1832-42.
11. Widmer KH, Zurfluh B. Component positioning of Total Hip components for optimal range of motion. J Orthop Res 2004; 22:815-21.
12. Wines AP, McNicol D. Computed Tomographic measurement of accuracy of component revision of Total Hip Arthroplasty. J. Arthroplasty 2006; 21:696-701.
13. Komeno M, Hasegawa M, Sudo A, Uchida A. Computed Tomographic evaluation of component position on dislocation after Total Hip Arthroplasty. Orthopaedics 2006; 29:1104-8.
14. Maheshwari AV, Jain AK, Zwolodzki MP, G Siram G. Femoral neck anteversion, acetabular anteversion and combined anteversion in normal Indian population. A computed tomography study. Indian J Orthop 2010; 44:277-82.
15. Saika K, Bhuyan S, Rangphar R. Anthropometric study of hip joint in Northeastern population with computed tomographic scan. Indian J Orthop, 2008; 42:260-6.
16. Nagar M, Bhardwaj R, Prakash R. Anteversion in adult Indian femora. J Anat Soc India 2002; 49:9-12.
17. Siwach RC, Dahiya S. Anthropometric study of proximal femoral geometry and its clinical application. Indian J Orthop 2003; 37:247-51.
18. Jain AK, Maheshwari AV, Nath S, Singh MP, Bhargava SK. Femoral neck anteversion: A comprehensive Indian study. Indian J Orthop 2005; 39:137-44.
19. Souza RB, Powers CM. Concurrent criteria – related validity and reliability of a clinical test to measure femoral anteversion. J Orthop Sports Phys Ther 2009; 39(8):586-92.
20. Svenningsen S, Terjesen T, Auflem M, Berg V. Hip rotation and in-toeing gait: a study of normal subjects from four years to adult age. Clin Orthop 1990; 251:177-82.
21. Tomezak RJ, Guenther KP, Rieber A. MR imaging measurement of femoral anteversion as a new technique: comparison with CT in children and adults. Am J Rad 1997; 168:791- 8.
22. Guenther KP, Tomczak R, Kessler S, Pfeiffer T, Puhl W. Measurement of femoral anteversion by magnetic resonance imaging-evaluation of a new technique in children and adolescents. Eur J Radiol 1995 ;21:47-52.
23. Hsiseth A, Reikeras O, Fsnstelien E. Lack of correlation between femoral neck anteversion and acetabular orientation. Acra Orthop Scand 1989; 60(1):93-6.
24. Schneider B, Laubenberger J, Jemlich S. Measurement of femoral anteversion and tibial torsion by MRI. Br J Rad 1997;70:575-9.
25. Bauman PA, Singson R, Hamilton WG. Femoral neck anteversion in ballerinas. Clin OrthopRelat Res 1994;302:57-63.
26. Koenig JK, Pring ME, Dwek JR. MR evaluation of femoral neck version and tibial torsion. Pediatr Radiol 2012;42(1):113-5.
27. Abd R. Muhamad, Joana M. Freitas, James D. Bomar, Jerry Dwek and Harish S. Hosalkar. “CT and MRI lower extremity torsional profile studies: measurement reproducibility”. J Child Orthop. 2012; 6(5): 391–396.
28. Shital Parikh and Frank R. Noyes. “Role of Computed Tomography and Magnetic Resonance Imaging in Defining Abnormal Rotational Lower Limb Alignment”. Sports Health. 2011; 3(2): 158–169
29. Reikerås O, Bjerkreim I, Kolbenstvedt A. “Anteversion of the acetabulum and femoral neck in normals and in patients with osteoarthritis of the hip”. Acta Orthop Scand. 1983; 54: 18–23.
30. Christopher Amuwa, MD, and Lawrence D. Dorr, MD. “The Combined Anteversion Technique for Acetabular Component Anteversion”. The Journal of Arthroplasty. 2008; 23: 1068-1070.

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Published

Feb 6, 2024

DOI https://doi.org/10.53555/jptcp.v31i2.4334

How to Cite

Dr. Ashish Agrawal, & Dr. Yashkumar B. Shihora. (2024). ESTIMATION OF MEAN VALUES OF FEMORAL ANTEVERSION, ACETABULAR ANTEVERSION, COMBINED ANTEVERSION AND ANTEVERSION RATIO IN NORMAL INDIAN POPULATION: AN MRI BASED STUDY. Journal of Population Therapeutics and Clinical Pharmacology, 31(2), 247–253. https://doi.org/10.53555/jptcp.v31i2.4334