ArticleBMC musculoskeletal disorders2026
Femoral neck anteversion- what's normal in Indians: a morphological study of 742 hips using CT-based MAKO robotic evaluation.
Article in BMC musculoskeletal disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundFemoral neck anteversion (FNA) is a key determinant of hip biomechanics and component positioning in total hip arthroplasty (THA). Most reference values for femoral version are derived from Western populations and non-robotic measurement techniques. Data defining native femoral version in the Indian population using CT-based robotic planning are limited.
methodsThis multicenter cross-sectional study analyzed 742 hips undergoing primary robotic-assisted THA using the MAKO THA 4.0 system. Native femoral version was calculated automatically from preoperative CT scans as the angle between the femoral neck axis and the trans-epicondylar axis. Femoral version was categorized as retroversion (< 0°), neutral (0°), or anteversion (> 0°). Descriptive statistics were reported as Mean (SD). Group comparisons were performed using chi-square tests, with statistical significance set at p < 0.05.
resultsThe mean native femoral version was - 2.6° (SD 11.9), with a range from - 42° to 41°. Overall, 395 hips (53.2%) demonstrated retroversion, 320 hips (43.1%) anteversion, and 27 hips (3.6%) neutral alignment. Retroversion predominated in males, whereas females showed significantly higher anteversion (p < 0.001). No statistically significant differences were observed across age groups (p = 0.310; Spearman ρ = 0.034, p = 0.356) or diagnosis categories (p = 0.227). Notably, 703 hips (94.7%) demonstrated femoral version below 15°.
conclusionIndian patients undergoing THA demonstrate substantially lower femoral neck anteversion than commonly cited Western norms, with more than half exhibiting femoral retroversion. These findings highlight the importance of population-specific and individualized preoperative planning, for which CT-based assessment can be useful.
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