Variation in femoral anteversion in patients requiring total hip replacement. HIP International, 30(3), 281–287.

Variation in femoral anteversion in patients requiring total hip replacement

Pierrepont, J. W., Marel, E., Baré, J. V., Walter, L. R., Stambouzou, C. Z., Solomon, M. I., … Shimmin, A. J. (2020).

Optimal implant alignment is important for total hip replacement (THR) longevity. Femoral stem anteversion is influenced by the native femoral anteversion. Knowing a patient’s femoral morphology is therefore important when planning optimal THR alignment. We investigated variation in femoral anteversion across a patient population requiring THR.

Preoperatively, native femoral neck anteversion was measured from 3-dimensional CT reconstructions in 1215 patients.

The median femoral anteversion was 14.4° (−27.1–54.5°, IQR 7.4–20.9°). There were significant gender differences (males 12.7°, females 16.0°; p < 0.0001). Femoral anteversion in males decreased significantly with increasing age. 14% of patients had extreme anteversion (<0° or >30°).

This is the largest series investigating native femoral anteversion in a THR population. Patient variation was large and was similar to published findings of a non-THR population. Gender and age-related differences were observed. Native femoral anteversion is patient-specific and should be considered when planning THR.

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