What is normal femoral head/neck anatomy? An analysis of radial CT reconstructions in adolescents

Amir A. Jamali, Walter Mak, Ping Wang, Lynn Tai, John Meehan, Ramit Lamba

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: Cam morphology in femoroacetabular impingement has been implicated in the development of osteoarthritis. The alpha angle and femoral head/neck offset are widely used to determine femoral head asphericity. To our knowledge, no study has evaluated the alpha angle circumferentially using three-dimensional imaging in a population of healthy individuals of adolescent age. Questions/purposes: We sought to (1) determine normal values for the alpha angle in adolescents, (2) define the location along the neck with the highest alpha angle, and (3) determine normal femoral head and neck radii and femoral head/neck offset. Methods: Fifty CT scans from a database of scans obtained for reasons not related to hip pain were studied. The average age of the subjects was 15 years (range, 14-16 years). Alpha angle and femoral head/neck offset were measured circumferentially. Results: The alpha angle averaged 40.66 ± 4.46 mm for males and 37.77 ± 5.65 mm for females. The alpha angle generally was highest between the 11:40 and 12:40 o'clock and between the 6:00 and 7:40 o'clock positions. The femoral head radius was 24.53 ± 1.74 mm for males and 21.94 ± 1.13 mm for females, and the femoral neck radius was 16.14 ± 2.32 mm for males and 13.82 ± 2.38 mm for females. The mean femoral head/neck offset was 8.39 ± 1.97 mm for males and 8.13 ± 2.27 mm for females. Conclusions: In this healthy population of 14- to 16-year-old subjects, the highest alpha angle was at the superior and inferior aspects of the heads rather than at the anterosuperior aspect. This information will provide benchmark values for distinction between normal and abnormal morphologic features of the femoral head. Level of Evidence: Level III, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.

Original languageEnglish (US)
Pages (from-to)3581-3587
Number of pages7
JournalClinical Orthopaedics and Related Research
Volume471
Issue number11
DOIs
StatePublished - Nov 2013

Fingerprint

Femur Neck
Anatomy
Thigh
Femoracetabular Impingement
Benchmarking
Three-Dimensional Imaging
Osteoarthritis
Population
Hip
Reference Values
Neck
Head
Databases
Guidelines
Pain

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

What is normal femoral head/neck anatomy? An analysis of radial CT reconstructions in adolescents. / Jamali, Amir A.; Mak, Walter; Wang, Ping; Tai, Lynn; Meehan, John; Lamba, Ramit.

In: Clinical Orthopaedics and Related Research, Vol. 471, No. 11, 11.2013, p. 3581-3587.

Research output: Contribution to journalArticle

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abstract = "Background: Cam morphology in femoroacetabular impingement has been implicated in the development of osteoarthritis. The alpha angle and femoral head/neck offset are widely used to determine femoral head asphericity. To our knowledge, no study has evaluated the alpha angle circumferentially using three-dimensional imaging in a population of healthy individuals of adolescent age. Questions/purposes: We sought to (1) determine normal values for the alpha angle in adolescents, (2) define the location along the neck with the highest alpha angle, and (3) determine normal femoral head and neck radii and femoral head/neck offset. Methods: Fifty CT scans from a database of scans obtained for reasons not related to hip pain were studied. The average age of the subjects was 15 years (range, 14-16 years). Alpha angle and femoral head/neck offset were measured circumferentially. Results: The alpha angle averaged 40.66 ± 4.46 mm for males and 37.77 ± 5.65 mm for females. The alpha angle generally was highest between the 11:40 and 12:40 o'clock and between the 6:00 and 7:40 o'clock positions. The femoral head radius was 24.53 ± 1.74 mm for males and 21.94 ± 1.13 mm for females, and the femoral neck radius was 16.14 ± 2.32 mm for males and 13.82 ± 2.38 mm for females. The mean femoral head/neck offset was 8.39 ± 1.97 mm for males and 8.13 ± 2.27 mm for females. Conclusions: In this healthy population of 14- to 16-year-old subjects, the highest alpha angle was at the superior and inferior aspects of the heads rather than at the anterosuperior aspect. This information will provide benchmark values for distinction between normal and abnormal morphologic features of the femoral head. Level of Evidence: Level III, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.",
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