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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
ORTHOPEDIC AND TRAUMATOLOGIC SURGERY OF THE HIP 98° CONGRESS OF THE PIEDMONTESE-LIGURIAN-LOMBARD SOCIETY OF ORTHOPEDICS AND TRAUMATOLOGY (SPLLOT) (Loano, October 19-20, 2001)
Minerva Ortopedica e Traumatologica 2001 June;52(3):129-34
Morphological changes in the healthy femur: a radiographic study and clinical implications
Massè A., Motta Navas M. J., Santoro D., Nicodemo A., Gallinaro P.
Background. The great increase in the life of the hip prostheses makes the comprehension of the bone resorption every day more important. Literature is surprisingly poor in the description of macroscopic bone changes and mostly looks on modifications in femurs with stems inside. The aim of this work is the in vivo assessment of the temporal radiological changes in the healthy femur in each single patient, sorted by age and sex.
Methods. Preliminary analysis of 17 patient with unilateral hip prosthesis was carried out. Measurements were made on the AP pelvis-radiograph executed either for the pre-operative planning or for the after-surgery examination and on the latest X-ray with the same projection. 4 different dimensions were considered (endosteal and periosteal diameter, medial and lateral cortical thickness) at 6 levels: these measures were divided by the correspondings taken 10 cm below the lesser trochanter. The correlation indexes between the first and the second radiograph were calculated. The variations were related to age, sex and follow-up.
Results. This study's results demonstrate that there are morphological changes of the endosteal canal in the proximal femur: while the medial cortical becomes narrower, the canal widens, trending, with time, towards the cylindrical shape.
Conclusions. In conclusion, in the light of the results obtained, the progressive enlargement of the femoral canal in the medium term appears to create a gap at the interface, which may be a concomitant cause in the development of prosthesis mobility.