Abstract：
BACKGROUND: The goal of this study was to better understand the variation of femoral neck version according to spinopelvic and lower limb 3D alignment using biplanar X-rays in standing position.
METHODS: This multicentric study retrospectively included healthy subjects from previous studies who had free-standing position biplanar radiographs. Subjects were excluded if they presented spinal or any musculo-skeletal deformity, and reported pain in the spine, hip or knee. Age, sex, and the following 3D-reconstructed parameters were collected: spinal curvatures, pelvic parameters, sagittal vertical axis (SVA), T1 pelvic angle (TPA), spino-sacral angle (SSA), femoral torsion angle (FTA), sacro-femoral angle (SFA), knee flexion angle (KA), ankle angle (AA), pelvic shift (PS) and ankle distance. Femoral neck version angle (FVA) was calculated between horizontal plane projection of the bi-coxo-femoral axis and the line passing through the femoral neck barycenter and femoral head center. Analysis according to age subsets was performed.
RESULTS: A total of 400 subjects were included (219 females); mean age was 29 ± 18 years (range: 4-83). Subjects with high pelvic tilt values presented significantly higher FVA than average and low-PT individuals, respectively, 7.8 ± 7.1°, 2 ± 9° and 2.1 ± 9.5° (p < 0.001). These subjects also presented lower lumbar lordosis values and higher acetabulum anteversion in the horizontal plane than the two other groups. SVA correlation with FVA was weaker (r = 0.1, p = 0.03) than SSA and TPA (r = - 0.3 and r = 0.3, respectively, p < 0.001). A strong correlation was found with femoral torsion (r = 0.5, p < 0.001). SFA (r = - 0.3, p < 0.001), pelvic shift (r = 0.2, p < 0.001) and ankle distance (r = 0.3, p < 0.001) were also significantly correlated. Multivariate analysis confirmed significant association of age, pelvic tilt, lumbar lordosis, pelvic shift, ankle distance and femoral torsion with FVA.
CONCLUSIONS: Patients with lower lumbar lordosis present pelvic retroversion which induces a higher femoral neck version. This finding may help positioning implants in total hip replacement procedures. Higher pelvic shift, age, male gender and increased femoral torsion were also correlated with higher FVA.
METHODS: II (Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding).
METHODS: This multicentric study retrospectively included healthy subjects from previous studies who had free-standing position biplanar radiographs. Subjects were excluded if they presented spinal or any musculo-skeletal deformity, and reported pain in the spine, hip or knee. Age, sex, and the following 3D-reconstructed parameters were collected: spinal curvatures, pelvic parameters, sagittal vertical axis (SVA), T1 pelvic angle (TPA), spino-sacral angle (SSA), femoral torsion angle (FTA), sacro-femoral angle (SFA), knee flexion angle (KA), ankle angle (AA), pelvic shift (PS) and ankle distance. Femoral neck version angle (FVA) was calculated between horizontal plane projection of the bi-coxo-femoral axis and the line passing through the femoral neck barycenter and femoral head center. Analysis according to age subsets was performed.
RESULTS: A total of 400 subjects were included (219 females); mean age was 29 ± 18 years (range: 4-83). Subjects with high pelvic tilt values presented significantly higher FVA than average and low-PT individuals, respectively, 7.8 ± 7.1°, 2 ± 9° and 2.1 ± 9.5° (p < 0.001). These subjects also presented lower lumbar lordosis values and higher acetabulum anteversion in the horizontal plane than the two other groups. SVA correlation with FVA was weaker (r = 0.1, p = 0.03) than SSA and TPA (r = - 0.3 and r = 0.3, respectively, p < 0.001). A strong correlation was found with femoral torsion (r = 0.5, p < 0.001). SFA (r = - 0.3, p < 0.001), pelvic shift (r = 0.2, p < 0.001) and ankle distance (r = 0.3, p < 0.001) were also significantly correlated. Multivariate analysis confirmed significant association of age, pelvic tilt, lumbar lordosis, pelvic shift, ankle distance and femoral torsion with FVA.
CONCLUSIONS: Patients with lower lumbar lordosis present pelvic retroversion which induces a higher femoral neck version. This finding may help positioning implants in total hip replacement procedures. Higher pelvic shift, age, male gender and increased femoral torsion were also correlated with higher FVA.
METHODS: II (Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding).
摘要：
背景：这项研究的目的是在站立时使用双平面X射线更好地了解根据脊柱骨盆和下肢3D对准的股骨颈版本的变化。
方法：这项多中心研究回顾性地纳入了先前研究中具有独立体位双平面X线照片的健康受试者。如果受试者出现脊柱或任何肌肉骨骼畸形，则将其排除在外。报告说脊柱疼痛，臀部或膝盖。年龄,性别,并收集了以下三维重建参数：脊柱曲率，骨盆参数,矢状垂直轴(SVA),T1骨盆角(TPA),脊柱-骶骨角(SSA),股骨扭转角（FTA），骶股骨角(SFA),膝关节屈曲角度(KA),脚踝角度（AA），骨盆移位（PS）和踝关节距离。在双股股轴的水平面投影与穿过股骨颈重心和股骨头中心的线之间计算股骨颈弯曲角（FVA）。根据年龄子集进行分析。
结果：共纳入400名受试者（219名女性）；平均年龄为29±18岁（范围：4-83）。高骨盆倾斜值的受试者表现出明显高于平均水平和低PT个体的FVA。分别,7.8±7.1°,2±9°和2.1±9.5°(p<0.001)。与其他两组相比，这些受试者的腰椎前凸值较低，水平面的髋臼前倾较高。SVA与FVA的相关性（r=0.1，p=0.03）弱于SSA和TPA（分别为r=-0.3和r=0.3，p<0.001)。发现与股扭转有很强的相关性（r=0.5，p<0.001）。SFA（r=-0.3，p<0.001），骨盆移位（r=0.2，p<0.001）和踝关节距离（r=0.3，p<0.001）也显着相关。多变量分析证实了年龄的显著关联，骨盆倾斜,腰椎前凸,骨盆移位,踝关节距离和股骨扭转与FVA。
结论：腰椎前凸较低的患者会出现骨盆后倾，从而导致股骨颈变高。这一发现可能有助于在全髋关节置换手术中定位植入物。较高的骨盆移位，年龄,男性和股骨扭转增加也与较高的FVA相关。
方法：II（诊断：具有一致应用参考标准和盲法的个体横断面研究）。
方法：这项多中心研究回顾性地纳入了先前研究中具有独立体位双平面X线照片的健康受试者。如果受试者出现脊柱或任何肌肉骨骼畸形，则将其排除在外。报告说脊柱疼痛，臀部或膝盖。年龄,性别,并收集了以下三维重建参数：脊柱曲率，骨盆参数,矢状垂直轴(SVA),T1骨盆角(TPA),脊柱-骶骨角(SSA),股骨扭转角（FTA），骶股骨角(SFA),膝关节屈曲角度(KA),脚踝角度（AA），骨盆移位（PS）和踝关节距离。在双股股轴的水平面投影与穿过股骨颈重心和股骨头中心的线之间计算股骨颈弯曲角（FVA）。根据年龄子集进行分析。
结果：共纳入400名受试者（219名女性）；平均年龄为29±18岁（范围：4-83）。高骨盆倾斜值的受试者表现出明显高于平均水平和低PT个体的FVA。分别,7.8±7.1°,2±9°和2.1±9.5°(p<0.001)。与其他两组相比，这些受试者的腰椎前凸值较低，水平面的髋臼前倾较高。SVA与FVA的相关性（r=0.1，p=0.03）弱于SSA和TPA（分别为r=-0.3和r=0.3，p<0.001)。发现与股扭转有很强的相关性（r=0.5，p<0.001）。SFA（r=-0.3，p<0.001），骨盆移位（r=0.2，p<0.001）和踝关节距离（r=0.3，p<0.001）也显着相关。多变量分析证实了年龄的显著关联，骨盆倾斜,腰椎前凸,骨盆移位,踝关节距离和股骨扭转与FVA。
结论：腰椎前凸较低的患者会出现骨盆后倾，从而导致股骨颈变高。这一发现可能有助于在全髋关节置换手术中定位植入物。较高的骨盆移位，年龄,男性和股骨扭转增加也与较高的FVA相关。
方法：II（诊断：具有一致应用参考标准和盲法的个体横断面研究）。
