title: The Morphology of the Proximal Femoral Canal Continues to Change in the Very Elderly: Implications for Total Hip Arthroplasty.
abstract: A shape mismatch between cementless stems and the femoral canal of very elderly patients could partly explain the inferior performance of cementless compared to cemented stems in this age group. Influences of age and gender on canal morphology were investigated by measuring coronal/sagittal dimensions on CT-scans of subjects ≥80 years old (n = 117) and subjects < 80 years old (n = 51). Absolute canal dimensions like width were larger in octogenarians than in younger subjects. These differences were larger in the sagittal plane than in the coronal plane (P < 0.001). Canal flaring changed asymmetrically with increased medial and less lateral flaring in octogenarians. Age-related changes were mainly observed in females and should be taken into consideration for implant design, selection and implantation in octogenarians.
authors.affiliation: AHORSE Research Foundation, Atrium Medical Center Heerlen, Dept. of Orthopaedic Surgery, Heerlen, the Netherlands.
authors.forename: Tim A E J
authors.initials: TA
authors.lastname: Boymans
authors.affiliation: AHORSE Research Foundation, Atrium Medical Center Heerlen, Dept. of Orthopaedic Surgery, Heerlen, the Netherlands.
authors.forename: Ide C
authors.initials: IC
authors.lastname: Heyligers
authors.affiliation: AHORSE Research Foundation, Atrium Medical Center Heerlen, Dept. of Orthopaedic Surgery, Heerlen, the Netherlands.
authors.forename: Bernd
authors.initials: B
authors.lastname: Grimm
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D003430:Cross-Sectional Studies; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D005270:Femur Head / Q000000981:diagnostic imaging* / Q000601:surgery*; D020342:Finite Element Analysis; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D012737:Sex Factors; D014057:Tomography, X-Ray Computed
keywords: canal flare index; cementless total hip arthroplasty; hip morphology; proximal femur; very elderly