A comparative analysis of morphological parameters in south indian hip joints with review of literature

Introduction: The morphology of the proximal femur is an essential parameter in the design and development of implants for total hip replacement. Inappropriate implant design and size could affect the outcome of the surgery with reported complications such as stress shielding, micromotion, and loosening. Most of these implants are designed and manufactured in the European and North American regions, which are presumably based on the morphology of their respective populations. In this study, we try to demonstrate the significant variation in the morphology of South Indian hip joints compared to other ethnicities. Material and Methods: This prospective study includes the study of the morphology of 400 adult hip joints. The patients presented to our hospital with complaints other than that related to the hip joint. Various parameters were studied, comprehensively discussed, and compared with other studies done in different ethnic groups. Results: The hip joints of the South Indian population have a significantly smaller femoral head diameter and offsets, narrower neck width, and medullary canal diameter when compared to other ethnic groups. The neck-shaft angle was comparable to results from other studies. Gender- and laterality-based variations were observed as well. Discussion and Conclusion: Our study demonstrated that the South Indian hip joints are significantly smaller when compared to other Asian hip joints. There were significant gender- and laterality-based variations. This study also provides evidence that implants could be modified to replicate the morphology of the native hip joints.