title: The innominate tubercle of the femur: Application to anterior surgical approaches to the hip.
abstract: There has recently been an increase in popularity of the direct anterior approach (DAA) hip arthroplasty, due to the muscle sparing nature of its interneural intervals, with the innominate tubercle being used as a lateral reference point for the femoral neck osteotomy. However, there is very little information in the literature on this rather enigmatic structure, with no evidence as to whether it is a consistent and reliable marker, or if it varies significantly in the population. In this study, data were gathered from 79 pairs of adult, post-medieval skeletal femora to investigate the effects of sex, age, femoral side, femoral length, femoral neck length, and femoral neck-shaft angle on the width, length, and height of the innominate tubercle. The sex, age, and date of death of the individuals had been recorded. Statistical analysis included canonical correlation and multivariate multiple regression. We found that there was no statistical significance or correlation between the width, length, or height of the tubercle with respect to any of the variables investigated. These results suggest that the innominate tubercle does not differ markedly between individuals in the Caucasian population, and, is therefore, a reliable landmark for femoral neck osteotomy during DAA hip arthroplasty. We present what we believe to be a definitive survey of the variability of the innominate tubercle in a Caucasian population. Clin. Anat. 30:578-584, 2017. © 2017 Wiley Periodicals, Inc.
authors.affiliation: Institute of Medical and Biomedical Education (Anatomy), St George's, University of London, London, United Kingdom.
authors.forename: O
authors.initials: O
authors.lastname: Kielbasinski Podlaszewska
authors.affiliation: The Centre for Human Bioarchaeology, Musuem of London, London, United Kingdom.
authors.forename: J
authors.initials: J
authors.lastname: Bekvalac
authors.affiliation: Department of Trauma and Orthopaedics, Hywel Dda University Health Board, United Kingdom.
authors.forename: R L
authors.initials: RL
authors.lastname: Williams
authors.affiliation: Institute of Medical and Biomedical Education (Anatomy), St George's, University of London, London, United Kingdom.
authors.forename: P J
authors.identifier: http://orcid.org/0000-0001-8913-0669
authors.initials: PJ
authors.lastname: Adds
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059925:Anatomic Landmarks; D063405:Anatomic Variation; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D005272:Femur Neck / Q000033:anatomy & histology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D012016:Reference Values; D055815:Young Adult
keywords: arthroplasty; direct anterior approach; femoral osteotomy; femur; femur neck; innominate tubercle