Introduction: The morphology of the proximal femur
differs in various populations. Based on our clinical
experience, conventional femoral stems used in hip
arthroplasty do not fit the Chinese population well. Hence,
this study aims to evaluate the suitability of conventional
femoral stems in the elderly Chinese hip fracture population
requiring hip arthroplasty and to establish if gender and age
related differences exist within this population.
Materials and methods: We retrospectively analysed
radiographic data of 300 patients from a tertiary hospital’s
geriatric hip fracture database who underwent either hip
hemi-arthroplasties or total hip arthroplasties. Proximal
femur morphological measurements were recorded, analysed
and compared to that of commonly used femoral stems.
Subgroup analysis was performed to compare age and
gender related differences.
Results: A total of 18.3% of the study population had a
medial femoral offset (MFO) of less than 30mm, which is the
smallest available offset for the implants studied. 22.6% of
female and 3% of male subjects had MFOs that were less
than 30mm. In our subgroup analysis, males had
significantly larger femoral head diameters, MFO and
vertical femoral offsets compared to females. Older subjects
(75-90 years old) had significantly smaller femoral head
diameters, vertical femoral offsets and neck shaft angles
compared to younger subjects (60-75 years old).
Conclusion: Commonly used femoral stem implants have
measurements that do not suit our Chinese population with
small medial femoral offsets. In addition, elderly males have
significantly larger femoral head diameters, medial and
vertical femoral offsets whereas older subjects have
significantly smaller femoral head diameters, vertical
femoral offsets and neck shaft angles.