Investigation of the femoral inclination and Alsberg angles according to age and gender in adults

Abstract

Objectives: The objective of our study was to examine the changes in the inclination and Alsberg angles of the femur in terms of age and gender. Methods: The present study was conducted on X-Ray images of 208 healthy individuals (103 males and 105 females) admitted to Bolu Abant Izzet Baysal University, Orthopedics and Traumatology Clinics. Both genders were separated into 3 different age groups. Statistical analyses were made to determine the difference between the gender and age groups. Results: The mean inclination angle of the femur was 132.88±7.08º on the right-side and 130.27±7.81º on the left. The mean Alsberg angle of the femur was 42.07±7.04º on the right-side and 41.43±7.03º on the left. The inclination angle was significantly higher in males than females on both sides and was significantly lower in 41–60 age group. The Alsberg angle was also significantly higher in males than females in 21–40 age group. Conclusion: The Alsberg angle is positively related with inclination angle, and subject to change by age. Knowing how IA and AA will be affected by age and gender and knowing the relation between these two angles will help to take a more accurate approach while evaluating and managing the follow up of a patient undergoing total hip arthroplasty, reconstructive surgery or planning physical theraphy.

Keywords

• age
• Alsberg angle
• gender
• inclination angle
• proximal femur

References

1. Shrestha R, Gupta HK, Hamal RR, Pandit R. Radiographic anatomy of the neck-shaft angle of femur in Nepalese people: correlation with its clinical ›mplication. Kathmandu Univ Med J (KUMJ) 2018; 16:124–8.
2. Oguz O. Measurement and relationship of the inclination angle, Alsberg angle and the angle between the anatomical and mechanical axes of the femur in males. Surg Radiol Anat 1996;18:29–31.
3. Noussios G, Theologou K, Chouridis P, Karavasilis G, Alafostergios G, Katsourakis A. A rare morphological study concerning the longest bone of the human anatomy in the population of the Northern Greece. J Clin Med Res 2019;11:740–4.
4. Gilligan I, Chandraphak S, Mahakkanukrauh P. Femoral neck-shaft angle in humans: variation relating to climate, clothing, lifestyle, sex, age and side. J Anat 2013;223:133–51.
5. Kafa IM, Arı I. The comparison of manuel and digital metric measurement methods in morphometric studies. Journal of Uluda¤ University Medical Faculty 2004;30:141–4.
6. Gui R, Canavese F, Liu S, Li L, Zhang L, Li Q. The potential role of the Alsberg angle as a predictor of lateral growth disturbance of the capital femoral epiphysis in children with developmental dysplasia of the hip treated by closed reduction. J Child Orthop 2020;14:106–11.
7. Boese CK, Dargel J, Oppermann J, Eysel P, Scheyerer MJ, Bredow J, Lechler P. The femoral neck-shaft angle on plain radiographs: a systematic review. Skeletal Radiol 2016;45:19–28.
8. Sertel Meyvaci S, Bamaç B, Duran B, Çolak T, Memiflo¤lu K. Effect of surgical and natural menopause on proximal femur morphometry in obese women. Ann Anat 2020;227:151416.

9. Heep H, Xu J, Löchteken C, Wedemeyer C. A simple and convenient method guide to determine the magnification of digital X-rays for preoperative planning in total hip arthroplasty. Orthop Rev (Pavia) 2012;3:12.
10. Pierre MA, Zurakowski D, Nazarian A, Hauser-Kara DA, Snyder BD. Assessment of the bilateral asymmetry of human femurs based on physical, densitometric, and structural rigidity characteristics. J Biomech 2010;43:2228–36.
11. Tahir A, Hassan AW, Umar IM. A study of the collodiaphyseal angle of the femur in the North-Eastern Sub-Region of Nigeria. Niger J Med 2001;10:34–6.
12. Anderson JY, Trinkaus E. Patterns of sexual, bilateral and interpopulational variation in human femoral neck-shaft angles. J Anat 1998;192:279–85.
13. Wee J, Sng BYJ, Shen L, Lim CT, Singh G, Das De S. The relationship between body mass index and physical activity levels in relation to bone mineral density in premenopausal and postmenopausal women. Arch Osteoporos 2013;8:162.
14. Corrado A, Cici D, Rotondo C, Maruotti N, Cantatore FP. Molecular basis of bone aging. Int J Mol Sci 2020;21:3679.
15. Jiang N, Peng L, Al-Qwbani M, Xie GP, Yang QM, Chai Y, Zhang Q, Yu B. Femoral version, neck-shaft angle, and acetabular anteversion in Chinese Han population. Medicine (Baltimore) 2015;94:e891.
16. Dretakis EK, Papakitsou E, Kontakis GM, Dretakis K, Psarakis S, Steriopoulos KA. Bone mineral density, body mass index, and hip axis length in postmenopausal Cretan women with cervical and trochanteric fractures. Calcif Tissue Int 1999;64:257–8.
17. Lee DH, Jung KY, Hong AR, Kim JH, Kim KM, Shin CS, Kim SY, Kim SW. Femoral geometry, bone mineral density, and the risk of hip fracture in premenopausal women: a case control study. BMC Musculoskelet Disord 2016;17:42.
18. Bergot C, Bousson V, Meunier A, Laval-Jeantet M, Laredo JD. Hip fracture risk and proximal femur geometry from DXA scans. Osteoporos Int 2002;13:542–50.