Differences in proximal femoral morphology between ethnicities may have implications on the design of cementless tapered wedge stems. This study analyses the differences in Asian and Caucasian bone morphology as well as the related fit of various cementless tapered wedge stem designs.
Methods:
A computed tomography database and modelling software was used to retrospectively analyse a total of 1345 femora. Ethnicity related comparisons as well as the fit of the stem designs were analysed.
Results:
Statistically significant differences between canal shape of Caucasian and Japanese as well as non-Japanese Asians were observed. The fit of the stems within the femoral canal was highly dependent on the respective stem shape.
Conclusions:
The shape differences in stem designs had a larger influence on the fit within the femoral canal than the differences in ethnicity related to bone morphology.
NoblePCAlexanderJWLindahlLJ, et al. The anatomic basis of femoral component design. Clin Orthop Relat Res1988; 235: 148–165.
2.
DorrLDFaugereMCMackelAM, et al. Structural and cellular assessment of bone quality of proximal femur. Bone1993; 14: 231–242.
3.
YangZJianWZhi-hanL, et al. The geometry of the bone structure associated with total hip arthroplasty. PLoS One2014; 9: e91058.
4.
SuXZhaoJZhaoZ, et al. Three-dimensional analysis of the characteristics of the femoral canal isthmus: an anatomical study. BioMed Res Int2015; 2015: 1–9.
5.
WuestemannTBastianASchmidtW, et al. A novel technique for studying proximal femoral bone morphology for hip implant design. In: 56th meeting of the orthopaedic research society, New Orleans, LA, 6–9 March 2010, poster no, 2217.
6.
UmerMSepahYJKhanA, et al. Morphology of the proximal femur in a Pakistani population. J Orthop Surg (Hong Kong)2010; 18: 279–281.
7.
TawadaKIguchiJTanakaN, et al. Is the canal flare index a reliable means of estimation of canal shape? Measurement of proximal femoral geometry by use of 3D models of the femur. J Orthop Sci2015; 20: 498–506.
8.
TakadaJBeckTJIbaK, et al. Structural trends in the aging proximal femur in Japanese postmenopausal women. Bone2007; 41: 97–102.
9.
SuganoNNoblePCKamaricE, et al. The morphology of the femur in developmental dysplasia of the hip. J Bone Joint Surg Br1998; 80: 711–719.
10.
RubinPJLezvrazPFAubaniacJM, et al. The morphology of the proximal femur. A three-dimensional analysis. J Bone Joint Surg Br1992; 74: 28–32.
11.
NoblePCKamaricESuganoN, et al. FThe three-dimensional shape of the dysplastic femur. Clin Orthop Relat Res2003; 417: 27–40.
12.
LaineHJLehtoUKMoilanenT.Diversity of proximal femoral medullary canal. J Arthroplasty2000; 15: 86–92.
13.
KhangGChoiKKimCS, et al. A study of Korean femoral geometry. Clin Orthop Relat Res2003; 406: 116–122.
14.
KaneujiAMatsumotoTNishinoM, et al. Three-dimensional morphological analysis of the proximal femoral canal, using computer-aided design system, in Japanese patients with osteoarthrosis of the hip. J Orthop Sci2000; 5: 361–368.
15.
HusmannORubinPJLeyvrazPF, et al. Three-dimensional morphology of the proximal femur. J Arthroplasty1997; 12: 444–450.
16.
BaharuddinMYSallehSHZulkiflyAH, et al. Morphological study of the newly designed cementless femoral stem. BioMed Res Int2014; 2014: 1–11.
17.
CasperDSKimGKRestrepoC, et al. Primary total hip arthroplasty with an uncemented femoral component five- to nine-year results. J Arthroplasty2011; 26: 838–841.
18.
HealyWLTilzeyJFIorioR, et al. Prospective, randomized comparison of cobalt–chrome and titanium trilock femoral stems. J Arthroplasty2009; 24: 831–836.
19.
PurtillJJRothmanRHHozackWJ, et al. Total hip arthroplasty using two different cementless tapered stems. Clin Orthop Relat Res2001; 393: 121–127.
20.
RileyARMontMAMalkaniAL, et al. Cementless tapered femoral stems for total hip arthroplasty in octogenarians. J Arthroplasty2016; 31: 2810–2813.
21.
MullerME.Hip joint prosthesis. In: Gebruder SulzerAGProtekAG (eds) United States Patent and Trademark Office, USA. Washington: US Patent and Trademark Office, 1982.
22.
IshiiSHommaYBabaT, et al. Does the canal fill ratio and femoral morphology of Asian females influence early radiographic outcomes of total hip arthroplasty with an uncemented proximally coated, tapered-wedge stem?J Arthroplasty2016; 31: 1524–1528.
23.
CooperHJJacobAPRodriguezJA.Distal fixation of proximally coated tapered stems may predispose to a failure of osteointegration. J Arthroplasty2011; 26: 78–83.
24.
MolliGMLombardiAVJrBerendRB, et al. A short tapered stem reduces intraoperative complications in primary total hip arthroplasty. Clin Orthop Relat Res2011; 470: 450.
25.
ManocchioAGJrBerendKRLombardiAV, et al. Early experience with a tapered titanium porous plasma sprayed stem with updated design. Surg Technol Int2017; 31: 231–235.
26.
WuestemannTBastianAParviziJ, et al. A novel tapered hip stem design optimized for femoral fit in a wide array of bone types. In: 12th EFORT congress, Copenhagen, Denmark, 1–4 June 2011.
27.
HoareSGWuestemannTPetersikA, et al. Is canal flare index a reliable measure of fit for contemporary femoral stem designs? In: Orthopaedic Research Society (ORS) annual meeting, San Diego, CA, 19–22 March 2017, poster no. 1099.
28.
BanerjeeSFaizanANevelosJ, et al. Innovations in hip arthroplasty three-dimensional modeling and analytical technology (SOMA). Surg Technol Int2014; 24: 288–294.
29.
SchröderMGottschlingHReimersN, et al. Automated morphometric analysis of the femur on large anatomical databases with highly accurate correspondence detection. Open Med J2009; 1: 15–22.
30.
GoodmanSB.The effects of micromotion and particulate materials on tissue differentiation: bone chamber studies in rabbits. Acta Orthop Scand Suppl1994; 258: 1–43.
31.
WuestemannTHydeESharkeyP.A novel technique for three dimensional analysis of bone contact area of various tapered wedge hip designs. In: Orthopaedic Research Society (ORS) annual meeting, San Diego, TX, 26–29 January 2013, poster no. 1850.
32.
VidalainJPSelmiTASBeverlandD, et al. The CORAIL® Hip System: a practical approach based on 25 years of experience. Berlin; Heidelberg: Springer, 2011.
