The importance of radiological parameters of proximal femoral morphology in recovery management of patients with avascular necrosis undergoing hip arthroplasty

Abstract

Background and Objectives: Our study aimed to radiologically assess the morphology of the proximal femur in patients with avascular necrosis (AVN). We considered that the correct evaluation of the proximal femur morphology is essential and shows multiple clinical applications that can impact patient recovery and outcome. Materials and Methods: Our study included 177 patients (85 male and 92 female) with AVN regardless of the degree. The patients were assessed by bilateral hip X-ray in the supine position. We selected the most common radiographic parameters to evaluate for all patients: cortical thickness index (CTI), canal flare index (CFI), calcar-to-canal ratio (CCR), and morphological cortical index (MCI). Results: Average values for the parameters were: CTI = 0.5192 ± 0.07528, CFI= 3.5515 ± 0.5071, CCR = 0.4469 ± 0.05363 and MCI = 2.7572 ± 0.07704. We found no statistically significant differences between genders, except for CFI (p = 0.0325). Conclusions: The anatomical configuration of the proximal femur can play a major role in the process of planning the appropriate implant for total hip arthroplasty, as well as in the proper positioning of the implant during the surgical procedure. A thorough knowledge of the proximal femur morphology can be of great use to the orthopedic surgeon and may help decrease perioperative complications.