3-DIMENSIONAL MORPHOLOGY OF THE PROXIMAL FEMUR

In the field of uncemented hip arthroplasties, secondary biologic fixa tion of femoral implants depends directly on the quality of the primar y stability. Metaphyseal filling and a good fit between the implant an d the proximal femur improve initial stabilization and optimize the tr ansmission of forces to the bone. Precise knowledge of the three-dimen sional femoral shape is essential to the design and selection of adapt ed implants. Three hundred ten femurs in 300 patients suffering from p rimary hip osteoarthritis were analyzed by computed tomography scannin g. After three-dimensional reconstruction, several measurements were e xtracted, and the parameters essential to the characterization of the diverse femoral morphologies encountered were identified. A new classi fication of the proximal femur is proposed. The consequences on the de sign and the preoperative selection of femoral implants are discussed.