Skip to main content
Top
Published in: Journal of Orthopaedic Surgery and Research 1/2008

Open Access 01-12-2008 | Research article

Asymmetry and structural system analysis of the proximal femur meta-epiphysis: osteoarticular anatomical pathology

Authors: Ali A Samaha, Alexander V Ivanov, John J Haddad, Alexander I Kolesnik, Safaa Baydoun, Maher R Arabi, Irena N Yashina, Rana A Samaha, Dimetry A Ivanov

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2008

Login to get access

Abstract

Background

The human femur is commonly considered as a subsystem of the locomotor apparatus with four conspicuous levels of organization. This phenomenon is the result of the evolution of the locomotor apparatus, which encompasses both constitutional and individual variability. The work therein reported, therefore, underlies the significance of observing anatomical system analysis of the proximal femur meta-epiphysis in normal conditions, according to the anatomic positioning with respect to the right or left side of the body, and the presence of system asymmetry in the meta-epiphysis structure, thus indicating structural and functional asymmetry.

Methods

A total of 160 femur bones of both sexes were compiled and a morphological study of 15 linear and angulated parameters of proximal femur epiphysis was produced, thus defining the linear/angulated size of tubular bones. The parameters were divided into linear and angulated groups, while maintaining the motion of the hip joint and transmission of stress to the unwanted parts of the limb. Furthermore, the straight and vertical diameters of the femoral head and the length of the femoral neck were also studied. The angle between the neck and diaphysis, the neck antiversion and angle of rotation of the femoral neck were subsequently measured. Finally, the condylo-diaphyseal angle with respect to the axis of extremity was determined. To visualize the force of intersystem ties, we have used the method of correlation galaxy construction.

Results

The absolute numeral values of each linear parameter were transformed to relative values. The values of superfluity coefficient for each parameter in the right and left femoral bone groups were estimated and Pearson's correlation coefficient has been calculated (> 0.60). Retrospectively, the observed results have confirmed the presence of functional asymmetry in the proximal femur meta-epiphysis. On the basis of compliance or insignificant difference in the confidence interval of the linear parameters, we have revealed, therefore, a discrepancy in values between the neck and the diaphysis angle and the angle of femoral neck rotation (range displacement of confident interval to a greater degree to the right).

Conclusion

This study assessed the observations of a systemic anatomical study encompassing the proximal femur meta-epiphysis behavior in normal condition. This work has significance in medical practice as the theoretical basis is also required in knowing the decreased frequency and degree of severity of osteoarthritic pathologies in the dominant lower extremity.
Appendix
Available only for authorised users
Literature
1.
go back to reference Samaha AA, Ivanov AV, Haddad JJ, Kolesnik AI, Baydoun S, Yashina IN, Samaha RA, Ivanov DA: Biomechanical and system analysis of the human femoral bone: Correlation and anatomical approach. J Orthop Surg Res. 2007, 2: 8-10.1186/1749-799X-2-8.PubMedCentralCrossRefPubMed Samaha AA, Ivanov AV, Haddad JJ, Kolesnik AI, Baydoun S, Yashina IN, Samaha RA, Ivanov DA: Biomechanical and system analysis of the human femoral bone: Correlation and anatomical approach. J Orthop Surg Res. 2007, 2: 8-10.1186/1749-799X-2-8.PubMedCentralCrossRefPubMed
2.
go back to reference Mayhew PM, Thomas CD, Clement JG, Loveridge N, Beck TJ, Bonfield W, Burgoyne CJ, Reeve J: Relation between age, femoral neck cortical stability, and hip fracture risk. Lancet. 2005, 366: 129-135. 10.1016/S0140-6736(05)66870-5.CrossRefPubMed Mayhew PM, Thomas CD, Clement JG, Loveridge N, Beck TJ, Bonfield W, Burgoyne CJ, Reeve J: Relation between age, femoral neck cortical stability, and hip fracture risk. Lancet. 2005, 366: 129-135. 10.1016/S0140-6736(05)66870-5.CrossRefPubMed
3.
go back to reference Wagner A, Sachse A, Keller M, Aurich M, Wetzel WD, Hortschansky P, Schmuck K, Lohmann M, Reime B, Metge J, Arfelli F, Menk R, Rigon L, Muehleman C, Bravin A, Coan P, Mollenhauer J: Qualitative evaluation of titanium implant integration into bone by diffraction enhanced imaging. Phys Med Biol. 2006, 51: 1313-1324. 10.1088/0031-9155/51/5/019.CrossRefPubMed Wagner A, Sachse A, Keller M, Aurich M, Wetzel WD, Hortschansky P, Schmuck K, Lohmann M, Reime B, Metge J, Arfelli F, Menk R, Rigon L, Muehleman C, Bravin A, Coan P, Mollenhauer J: Qualitative evaluation of titanium implant integration into bone by diffraction enhanced imaging. Phys Med Biol. 2006, 51: 1313-1324. 10.1088/0031-9155/51/5/019.CrossRefPubMed
4.
go back to reference Nikitiuk IE, Ovsiankin NA: The differential diagnosis of posttraumatic ossifications in the area of the elbow joint in children. Vestn Khir Im I I Grek. 1997, 156: 28-31.PubMed Nikitiuk IE, Ovsiankin NA: The differential diagnosis of posttraumatic ossifications in the area of the elbow joint in children. Vestn Khir Im I I Grek. 1997, 156: 28-31.PubMed
5.
go back to reference Cummings RG, Cauley JA, Palermo L, Ross PD, Wasnich RD, Black D, Faulkner KG: Racial differences in hip axis length might explain racial differences in rates of hip fracture. Study of osteoporotic oractures oesearch group. Osteoporosis Int. 1994, 4: 226-229. 10.1007/BF01623243.CrossRef Cummings RG, Cauley JA, Palermo L, Ross PD, Wasnich RD, Black D, Faulkner KG: Racial differences in hip axis length might explain racial differences in rates of hip fracture. Study of osteoporotic oractures oesearch group. Osteoporosis Int. 1994, 4: 226-229. 10.1007/BF01623243.CrossRef
7.
go back to reference Auerbach BM, Ruff CB: Limb bone bilateral asymmetry: Variability and commonality among modern humans. J Hum Evol. 2006, 50: 203-218. 10.1016/j.jhevol.2005.09.004.CrossRefPubMed Auerbach BM, Ruff CB: Limb bone bilateral asymmetry: Variability and commonality among modern humans. J Hum Evol. 2006, 50: 203-218. 10.1016/j.jhevol.2005.09.004.CrossRefPubMed
8.
go back to reference Livshits G, Yakovenko K, Kletselman L, Karasik D, Kobyliansky E: Fluctuating asymmetry and morphometric variation of hand bones. Am J Phys Anthropol. 1998, 107: 125-136. 10.1002/(SICI)1096-8644(199809)107:1<125::AID-AJPA10>3.0.CO;2-2.CrossRefPubMed Livshits G, Yakovenko K, Kletselman L, Karasik D, Kobyliansky E: Fluctuating asymmetry and morphometric variation of hand bones. Am J Phys Anthropol. 1998, 107: 125-136. 10.1002/(SICI)1096-8644(199809)107:1<125::AID-AJPA10>3.0.CO;2-2.CrossRefPubMed
9.
go back to reference Bass SL, Saxon L, Daly RM, Turner CH, Robling AG, Semaan E, Stuckey S: The effect of mechanical loading on the size and shape of bone in pre-, peri-, and postpubertal girls: A study tennis players. J Bone Miner Res. 2002, 17: 2274-2280. 10.1359/jbmr.2002.17.12.2274.CrossRefPubMed Bass SL, Saxon L, Daly RM, Turner CH, Robling AG, Semaan E, Stuckey S: The effect of mechanical loading on the size and shape of bone in pre-, peri-, and postpubertal girls: A study tennis players. J Bone Miner Res. 2002, 17: 2274-2280. 10.1359/jbmr.2002.17.12.2274.CrossRefPubMed
10.
go back to reference Gonzalez MH, Barmada R, Fabiano D, Meltzer W: Femoral shaft fracture after hip arthroplasty: A system for classification and treatment. J South Orthop Assoc. 1999, 8: 240-248.PubMed Gonzalez MH, Barmada R, Fabiano D, Meltzer W: Femoral shaft fracture after hip arthroplasty: A system for classification and treatment. J South Orthop Assoc. 1999, 8: 240-248.PubMed
11.
go back to reference Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR: Dislocation after total hip replacement arthroplasty. J Bone Joint Surg. 1978, 60: 217-220.PubMed Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR: Dislocation after total hip replacement arthroplasty. J Bone Joint Surg. 1978, 60: 217-220.PubMed
12.
go back to reference Noble PC, Alexander JW, Lindahl LJ, Yew DT, Granberry WM, Tullos HS: The anatomic basis of femoral component design. Clin Orthop Relat Res. 1988, 235: 148-165.PubMed Noble PC, Alexander JW, Lindahl LJ, Yew DT, Granberry WM, Tullos HS: The anatomic basis of femoral component design. Clin Orthop Relat Res. 1988, 235: 148-165.PubMed
13.
go back to reference L'ubusky M, Mickova I, Prochazka M, Dzvincuk P, Mala K, Cizek L, Janout V: Discrepancy of ultrasound biometric parameters of the head (HC – head circumference, BPD – biparietal diameter) and femur length in relation to sex of the fetus and duration of pregnancy. Ceska Gynekol. 2006, 71: 169-172.PubMed L'ubusky M, Mickova I, Prochazka M, Dzvincuk P, Mala K, Cizek L, Janout V: Discrepancy of ultrasound biometric parameters of the head (HC – head circumference, BPD – biparietal diameter) and femur length in relation to sex of the fetus and duration of pregnancy. Ceska Gynekol. 2006, 71: 169-172.PubMed
14.
go back to reference Upadhyay SS, Burwell RG, Moulton A, Small PG, Wallace WA: Femoral anteversion in healthy children, application of a new method using ultrasound. J Anat. 1990, 169: 49-61.PubMedCentralPubMed Upadhyay SS, Burwell RG, Moulton A, Small PG, Wallace WA: Femoral anteversion in healthy children, application of a new method using ultrasound. J Anat. 1990, 169: 49-61.PubMedCentralPubMed
15.
go back to reference Collins EH: The concept of relative limb dominance. Hum Biol. 1961, 33: 293-317.PubMed Collins EH: The concept of relative limb dominance. Hum Biol. 1961, 33: 293-317.PubMed
16.
go back to reference Turner RS: Postoperative total hip prosthetic femoral head dislocations. Incidence, etiologic, factors and management. Clin Orthop. 1994, 301: 196-204.PubMed Turner RS: Postoperative total hip prosthetic femoral head dislocations. Incidence, etiologic, factors and management. Clin Orthop. 1994, 301: 196-204.PubMed
17.
go back to reference Spruijt S, van der Linden JC, Dijkstra PD, Wiggers T, Oudkerk M, Snijders CJ, van Keulen F, Verhaar JA, Weinans H, Swierstra BA: Prediction of torsional failure in 22 cadaver femora with and without simulated subtrochanteric metastatic defects: A CT scan-based finite element analysis. Acta Orthop. 2006, 77: 474-481. 10.1080/17453670610046424.CrossRefPubMed Spruijt S, van der Linden JC, Dijkstra PD, Wiggers T, Oudkerk M, Snijders CJ, van Keulen F, Verhaar JA, Weinans H, Swierstra BA: Prediction of torsional failure in 22 cadaver femora with and without simulated subtrochanteric metastatic defects: A CT scan-based finite element analysis. Acta Orthop. 2006, 77: 474-481. 10.1080/17453670610046424.CrossRefPubMed
18.
go back to reference Theodorou SJ, Theodorou DJ, Resnick D: Imaging findings in symptomatic patients with femoral diaphyseal stress injuries. Acta Radiol. 2006, 47: 377-384. 10.1080/02841850600570508.CrossRefPubMed Theodorou SJ, Theodorou DJ, Resnick D: Imaging findings in symptomatic patients with femoral diaphyseal stress injuries. Acta Radiol. 2006, 47: 377-384. 10.1080/02841850600570508.CrossRefPubMed
19.
go back to reference Wisniewski SJ, Grogg B: Femoroacetabular impingement: An overlooked cause of hip pain. Am J Phys Med Rehabil. 2006, 85: 546-549. 10.1097/01.phm.0000219148.00549.e8.CrossRefPubMed Wisniewski SJ, Grogg B: Femoroacetabular impingement: An overlooked cause of hip pain. Am J Phys Med Rehabil. 2006, 85: 546-549. 10.1097/01.phm.0000219148.00549.e8.CrossRefPubMed
20.
go back to reference Estok DM, Harris WH: Long-term results of cemented femoral revision surgery using second-generation technique. An average 11,7-year follow-up evaluation. Clin Orthop. 1994, 299: 190-202.PubMed Estok DM, Harris WH: Long-term results of cemented femoral revision surgery using second-generation technique. An average 11,7-year follow-up evaluation. Clin Orthop. 1994, 299: 190-202.PubMed
21.
go back to reference McCollum DE, Gray WJ: Dislocation after total hip arthroplasty. Clin Orthop. 1990, 261: 159-170.PubMed McCollum DE, Gray WJ: Dislocation after total hip arthroplasty. Clin Orthop. 1990, 261: 159-170.PubMed
22.
go back to reference Morrey BF: Instability after total hip arthroplasty. Orthop Clin N America. 1992, 2: 237-248. Morrey BF: Instability after total hip arthroplasty. Orthop Clin N America. 1992, 2: 237-248.
23.
go back to reference Noble PC: Proximal femoral geometry and the design of cementless hip replacements. Orthop Rel Sci. 1990, 1: 86-92. Noble PC: Proximal femoral geometry and the design of cementless hip replacements. Orthop Rel Sci. 1990, 1: 86-92.
24.
go back to reference Takada J, Beck TJ, Iba K, Yamashita T: Structural trends in the aging proximal femur in Japanese postmenopausal women. Bone. 2007, 41: 97-102. 10.1016/j.bone.2007.04.178.CrossRefPubMed Takada J, Beck TJ, Iba K, Yamashita T: Structural trends in the aging proximal femur in Japanese postmenopausal women. Bone. 2007, 41: 97-102. 10.1016/j.bone.2007.04.178.CrossRefPubMed
25.
go back to reference Chiu FY: The native femoral sulcus as the guide for the medial/lateral position of the femoral component in knee arthroplasty: Normal patellar tracking in 690/700 knees – a prospective evaluation. Acta Orthop. 2006, 77: 501-504. 10.1080/17453670610046460.CrossRefPubMed Chiu FY: The native femoral sulcus as the guide for the medial/lateral position of the femoral component in knee arthroplasty: Normal patellar tracking in 690/700 knees – a prospective evaluation. Acta Orthop. 2006, 77: 501-504. 10.1080/17453670610046460.CrossRefPubMed
26.
go back to reference Efimov VA, Gorlin IK, Nechaev BN, Trgubov GP, Belavich NF: The use of new materials and structural-technological equipment in foreign medical technology. Med Tekh. 1981, 3: 38-43.PubMed Efimov VA, Gorlin IK, Nechaev BN, Trgubov GP, Belavich NF: The use of new materials and structural-technological equipment in foreign medical technology. Med Tekh. 1981, 3: 38-43.PubMed
27.
go back to reference Bell KL, Loveridge N, Reeve J, Thomas CD, Feik SA, Clement JG: Super-osteons (remodeling clusters) in the cortex of the femoral shaft: Influence of age and gender. Anat Rec. 2001, 264: 378-386. 10.1002/ar.10014.CrossRefPubMed Bell KL, Loveridge N, Reeve J, Thomas CD, Feik SA, Clement JG: Super-osteons (remodeling clusters) in the cortex of the femoral shaft: Influence of age and gender. Anat Rec. 2001, 264: 378-386. 10.1002/ar.10014.CrossRefPubMed
28.
go back to reference Hernandez-Vaquero D, Suarez-Vazquez A: Knee arthrodesis with navigation: A new indication for computer-assisted surgery? A case report. Knee. 2007, 14: 162-163. 10.1016/j.knee.2006.11.007.CrossRefPubMed Hernandez-Vaquero D, Suarez-Vazquez A: Knee arthrodesis with navigation: A new indication for computer-assisted surgery? A case report. Knee. 2007, 14: 162-163. 10.1016/j.knee.2006.11.007.CrossRefPubMed
29.
go back to reference Ensini A, Catani F, Leardini A, Romagnoli M, Giannini S: Alignments and clinical results in conventional and navigated total knee arthroplasty. Clin Orthop Relat Res. 2007, 457: 156-162.PubMed Ensini A, Catani F, Leardini A, Romagnoli M, Giannini S: Alignments and clinical results in conventional and navigated total knee arthroplasty. Clin Orthop Relat Res. 2007, 457: 156-162.PubMed
30.
go back to reference Weidow J, Karrholm J, Saari T, McPherson A: Abnormal motion of the medial femoral condyle in lateral knee osteoarthritis. Clin Orthop Relat Res. 2007, 454: 27-34. 10.1097/BLO.0b013e31802bab25.CrossRefPubMed Weidow J, Karrholm J, Saari T, McPherson A: Abnormal motion of the medial femoral condyle in lateral knee osteoarthritis. Clin Orthop Relat Res. 2007, 454: 27-34. 10.1097/BLO.0b013e31802bab25.CrossRefPubMed
31.
go back to reference Manner HM, Radler C, Ganger R, Grill F: Knee deformity in congenital longitudinal deficiencies of the lower extremity. Clin Orthop Relat Res. 2006, 448: 185-192. 10.1097/01.blo.0000218733.38753.90.CrossRefPubMed Manner HM, Radler C, Ganger R, Grill F: Knee deformity in congenital longitudinal deficiencies of the lower extremity. Clin Orthop Relat Res. 2006, 448: 185-192. 10.1097/01.blo.0000218733.38753.90.CrossRefPubMed
32.
go back to reference Li G, Zayontz S, DeFrate LE, Most E, Suggs JF, Rubash HE: Kinematics of the knee at high flexion angles: an in vitro investigation. J Orthop Res. 2004, 22: 90-95. 10.1016/S0736-0266(03)00118-9.CrossRefPubMed Li G, Zayontz S, DeFrate LE, Most E, Suggs JF, Rubash HE: Kinematics of the knee at high flexion angles: an in vitro investigation. J Orthop Res. 2004, 22: 90-95. 10.1016/S0736-0266(03)00118-9.CrossRefPubMed
33.
go back to reference Neame R, Zhang W, Deighton C, Doherty M, Doherty S, Lanyon P, Wright G: Distribution of radiographic osteoarthritis between the right and left hands, hips, and knees. Arthritis Rheum. 2004, 50: 1487-1494. 10.1002/art.20162.CrossRefPubMed Neame R, Zhang W, Deighton C, Doherty M, Doherty S, Lanyon P, Wright G: Distribution of radiographic osteoarthritis between the right and left hands, hips, and knees. Arthritis Rheum. 2004, 50: 1487-1494. 10.1002/art.20162.CrossRefPubMed
34.
35.
go back to reference O'Neill TW, Grazio S, Spector TD, Silman AJ: Geometric measurements of the proximal femur in UK women: secular increase between the late 1950s and early 1990s. Osteoporos Int. 1996, 6: 136-140. 10.1007/BF01623937.CrossRefPubMed O'Neill TW, Grazio S, Spector TD, Silman AJ: Geometric measurements of the proximal femur in UK women: secular increase between the late 1950s and early 1990s. Osteoporos Int. 1996, 6: 136-140. 10.1007/BF01623937.CrossRefPubMed
36.
go back to reference Schultz AH: Proportions, variability and asymmetries of the long bones of the limbs and te clavicles in man and apes. Hum Biol. 1937, 9: 281-328. Schultz AH: Proportions, variability and asymmetries of the long bones of the limbs and te clavicles in man and apes. Hum Biol. 1937, 9: 281-328.
Metadata
Title
Asymmetry and structural system analysis of the proximal femur meta-epiphysis: osteoarticular anatomical pathology
Authors
Ali A Samaha
Alexander V Ivanov
John J Haddad
Alexander I Kolesnik
Safaa Baydoun
Maher R Arabi
Irena N Yashina
Rana A Samaha
Dimetry A Ivanov
Publication date
01-12-2008
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2008
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/1749-799X-3-11

Other articles of this Issue 1/2008

Journal of Orthopaedic Surgery and Research 1/2008 Go to the issue