Femoral neck buttressing: a radiographic and histologic analysis.
OBJECTIVE
To examine the incidence, radiographic and histologic findings of medial femoral neck buttressing in a consecutive group of patients undergoing total hip arthroplasty.


METHODS
Biomechanical parameters were evaluated on standard anteroposterior pelvic radiographs of 113 patients prior to hip replacement surgery. Demographic information on all patients was reviewed and histologic evaluation was performed on specimens obtained at the time of surgery.


RESULTS
The incidence of medial femoral neck buttressing was found to be 50% in a consecutive series of patients undergoing total hip arthroplasty. The incidence was slightly higher in women (56% vs. 41%). Patients with buttressing had increased neck-shaft angles and smaller femoral neck diameters than were seen in patients without buttressing. Histologic evaluation demonstrated that the buttress resulted from deposition bone by the periosteum on the femoral neck in the absence of any evidence of femoral neck fracture.


CONCLUSIONS
It would appear that femoral neck buttressing occurs in response to increased joint reactive forces seen at the hip being transmitted through the femoral neck. The increased joint reactive force can be related to the increased neck shaft angle seen in patients with buttressing.
Dixon
T
T
University of Arizona Health Sciences Center, Tucson 85724, USA.
Benjamin
J
J
Lund
P
P
Graham
A
A
Krupinski
E
E
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D019644:Arthroplasty, Replacement, Hip; D001696:Biomechanical Phenomena; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging* / Q000473:pathology*; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D011859:Radiography