Type of Article:  Original Research

Volume 6; Issue 3.3 (Septmber 2018)

Page No.: 5698-5703

DOI: https://dx.doi.org/10.16965/ijar.2018.313


Diwakar Dhurandhar 1, Jagriti Agrawal *1, Deepti Chandrakar 1.

Department of Anatomy, Pt.J.N.M Medical College, Raipur.

* Correspondence to: Dr Jagriti Agrawal, Departmental Office, Department of Anatomy,  Pt.J.N.M Medical College, Raipur, India. Contact Number: +919826199757 E-Mail: jagritiagrawal28@gmail.com


Background: Femoral neck anteversion angle is the angle which measures the anterior rotation of the neck of the femur around the shaft. Its variation in the various population groups is attributed to various factors such as heredity, diet, climatic factors and lifestyle.  This angle is clinically significant for orthopedicians while doing hip arthroplasties and osteotomies where it is pertinent to restore the anatomy of proximal femur for stability of the hip joint.

Context and purpose of the study: There is no baseline data of Femoral Neck Anteversion angle for Central Indian population. The present study was aimed to fill this lacuna and to give the normal values of femoral neck anteversion angle for above specified population.

Materials and methods: 152 dried femora were procured from department of anatomy consisting of 77 femora of right side and 75 femora of left side. Anteversion angle is recorded using goniometer. Means were calculated and statistically correlated for laterality using independent student‘t’ test. p value was thus obtained.

Results: Mean anteversion angle of right side was found to be 19.03º ± 12.11º and that of the left side came out to be 18.62º ± 10.8º. Among 152 femora taken, 7 retroverted and 7 neutral verted femora were also found in the study.

Conclusion: So much variation in the angle of anteversion along with the presence of retroversion (4.6%) and neutral version (4.6%) is a challenge for both implant designer companies as well as orthopedicians. Thus, present study acts as a guide for normal values and range of this clinically significant angle.

KEY WORDS: Hip arthroplasty, Angle of anteversion, femur neck fracture, Anthropometry.


  1. Da Vinci L. Paris Manuscript K. 1503-08. (Bibliotheque de I’institut de France)
  2. Backman S. The proximal end of the femur. Acta Radiol 1957;146(Suppl):1-166.
  3. Umebese P, Adeyekun A, Moin M. Radiological assessment of femoral neck-shaft and anteversion angles in adult Nigerian hips. Niger Postgrad Med J 2005;12:106-9.
  4. Fabry G, MacEwen GD, Shands AR. Torsion of the femur: a follow-up study in normal and abnormal conditions. J Bone Joint Surg [Am] 1973;55-A:1726-38.
  5. Beals RK. Developmental changes in the femur and acetabulum in spastic paraplegia and diplegia. Dev Med Child Neurol 1969;11:303-13
  6. Lange F, Pitzen P. Zur anatomie des oberen femurendes. Z Orthop Chir 1921;41:105-34.
  7. McMinn, R.M.H. Lower limb. In: McMinn RMH editor. Last’s Anatomy: Regional and Applied. 9th Edition. Hong Kong. Elsevier; 2009.p 221.
  8. Solomon, L., Warwick, D and Nayagam, S. Pain around the hip. In: Solomon, L. editor. Apley’s system of orthopedics and fractures. 9th edition. London. Hodder and Arnold; 2010. p 561.
  9. Verma L, Porwal V, Ghulyani T. A study of morphological variations in femur: implications for use in orthopedic procedures. Int J Health Sci Res. 2016; 6(9):156-163.
  10. Williams A, Richard LM, Davies MS, Collins P. Gray’s Anatomy in Pelvic girdle, gluteal region and hip joint, 39th edn. Elsevier Churchill Livingstone, Edinburgh, pp.1431.
  11. Gulan G, Matovinoviæ D, Nemec B, Rubiniæ D, Ravlae-Gulan J. Femoral neck anteversion: values,development, measurement, common problems. Coll Antropol. 2000;24(2):521-7.
  12. Wedge JH, Munkacsi I, Loback D. Anteversion of the femur and idiopathic osteoarthrosis of the hip. J Bone Joint Surg Am.1989;71(7):1040-3.
  13. Maheshwari AV, Zlowodzki MP, Siram G, Jain AK. Femoral neck anteversion, acetabular anteversion and combined anteversion in the normal Indian adult population: A vcomputed tomographic study. Indian J Orthop. 2010 Jul;44(3):277-82.
  14. Jain AK, Maheshwari AV, Singh M.P, Nath S and Bhargav S.K,. Femoral neck anteversion: A comprehensive Indian study. Indian J. Orthop.2005;39:137-144.
  15. Shrikant AR, Arati KM, Sant SM. The angle of femoral anteversion in Indians. J. Anat. Soc. India 2009;58(2):161-65.
  16. 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: a retrospective analysis of 466 healthy adults. Medicine (Baltimore). 2015 May;94(21):e891.
  17. Ingalls NW. Studies on femur. Am J Phys Antrop 1924;7:207-255.
  18. Weinstein SL, Buckwaster JA. Turek’s orthopaedics in the paediatric foot. 6th edi. Philadelphea: Lippincott Williams and Wilkins;2005.
  19. Kingsley PC, Olmsted KL. A study to determine the angle of anteversion of the neck of the femur. J Bone Joint Surg Am. 1948;30A:745–751.
  20. Braten `Terjesen T, Rossvoll I. Femoral anteversion in normal adults. Ultrasound measurements in 50 men and 50 women. Acta Orthop Scand. 1992;63:29–32.
  21. Schneider B, Laubenberger J, Jemlich S, Groene K, Weber HM and Langer M. Measurement of fermoral anteversion and tibial torsion by magnetic resonance imaging. The British Journal of Radiology 1997;70:575-9.
  22. Husmann O, Rubin PJ, Leyvraz PF, et al. Three dimensional morphology of the proximal femur. J Arthroplasty. 1997;12:444–450.
  23. Sugano N, Noble PC, Kamaric E. A comparison of alternative methods of measuring femoral anteversion. J Comput Assist Tomogr. 1998 Jul-Aug;22(4):610-4.
  24. Maruyama M, Feinberg JR, Capello WN, et al. The Frank Stinchfield Award: Morphologic features of the acetabulum and femur: anteversion angle and implantpositioning. Clin Orthop Relat Res. 2001:52–65(393).
  25. Mahaisavariya B, Sitthiseripratip K, Tongdee T, et al. Morphological study of the proximal femur: a new method of geometrical assessment using 3-dimensional reverse engineering. Med Eng Phys. 2002;24:617–622.
  26. Kweon DC, Yang SH, Park P. Comparative Study in the Femoral Anteversion Measured by CT and MR Imaging as a PACS Image Viewer. Journal of Korean Society of Medical Informatics 2002 Dec; 8(04):21-27.
  27. Khang G, Choi K, Kim C, et al. A study of Korean femoral geometry. Clin Orthop Relat Res. 2003;406:116–122.
  28. Lee YS, Oh SH, Seon JK, et al. 3D femoral neck anteversion measurements based on the posterior femoral plane in ORTHODOC system. Med Biol Eng Comput.2006;44:895–906.
  29. Toogood PA, Skalak A, Cooperman DR. Proximal femoral anatomy in the normal human population. Clin Orthop Relat Res. 2009;467:876–885.
  30. Kulig K, Hanigan KH, Souza RB and Powers CM. Measurement of Femoral Torsion by Ultrasound and Magnetic Resonance Imaging: Concurrent Validity. PHYS THER 2010; 90:1641-8.
  31. Bargar WL, Jamali AA, Nejad AH. Femoral anteversion in THA and its lack of correlation with native acetabular anteversion. Clin Orthop Relat Res. 2010;468:527–532.
  32. Koerner JD, Patel NM, Yoon RS, Sirkin MS, Reilly MC, Liporace FA. Femoral version of the general population does “normal” vary by gender or ethnicity? J OrthopTrauma. 2013 Jun;27(6):308-11.
  33. Yun HH, Yoon JR, Yang JH, et al. A validation study for estimation of femoral anteversion using the posterior lesser trochanter line: an analysis of computed tomography measurement. J Arthroplasty. 2013;28:1776–1780.
  34. Wright SJ, Boymans TA, Grimm B, Miles AW, Kessler O. Strong correlation between the morphology of the proximal femur and the geometry of the distal femoral trochlea. Knee Surg Sports Traumatol Arthrosc. 2014 Dec;22(12):2900-10.
  35. Ming Han; Yongkui Zhang & Tao Shan. Femoral Offset and its Relationship to Femoral Neck-shaft Angle and Torsion Angle Int. J. Morphol.,32(4):1194-1198, 2014.
  36. Siwach RC, Dahiya S. Anthropometric study of proximal femur geometry and its clinical application. Indian J Orthop 2003;37:247-51.
  37. Nagar M, Bhardawaj R, Prakash R. Anteversion in adult Indian femora. J Anat Soc India 2000;49:9-12
  38. Saikia KC, Bhuyan S, Rongphar R. Anthropometric study of the hip joint in Northeastern region population with computed topography scan. Indian J Orthop 2008;42:260-6.
  39. Rokade S, A Mane. Femoral Anteversion: Comparison by Two Methods. The Internet Journal of Biological Anthropology. 2008 Volume 3 Number 1.
  40. Zalawadia DA, Ruparelia DS, Shah DS, Parekh DD, Patel DS, Rathod SP, Patel DSV. Study of Femoral Neck Anteversion of Adult Dry Femora in Gujarat Region. NJIRM. 2010;1(3):7-11.
  41. Rawal B, Ribeiro R, Malhotra R, et al. Anthropometric measurements to design best-fit femoral stem for theIndian population. Indian J Orthop. 2012;46:46–53.
  42. Ravichandran D, Devi Sankar K, Bhanu SP , Manjunath KY, Shankar R. Angle of Femoral Neck Anteversion in Andhra Pradesh Population of India Using Image Tool Software. JIMSA.2014;27(4):199-200.

Cite this article: Diwakar Dhurandhar, Jagriti Agrawal, Deepti Chandrakar. A STUDY OF FEMORAL NECK ANTEVERSION ANGLE IN CENTRAL INDIAN POPULATION: A GUIDE FOR ORTHOPAEDIC SURGERIES INCLUDING HIP ARTHROPLASTY. Int J Anat Res 2018;6(3.3):5698-5703. DOI: 10.16965/ijar.2018.313