***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective To evaluate if pelvic or hip width predisposed women to developing greater trochanteric pain syndrome ( GTPS ) . Design Prospect i ve case control study . Participants Four groups were included in the study : those gluteal tendon reconstructions ( n=31 , GTR ) , those with conservatively managed GTPS ( n=29 ) , those with hip osteoarthritis ( n=20 , OA ) and 22 asymptomatic participants ( ASC ) . Methods  Anterior-posterior pelvic x-rays were evaluated for femoral neck shaft angle ; acetabular index , and width at the lateral acetabulum , and the superior and lateral aspects of the greater trochanter . Body mass index  , and waist , hip and greater trochanter girth  were measured . Data were analysed using a one-way analysis of variance ( ANOVA ; posthoc Scheffe analysis ) , then multivariate analysis . Results The GTR group had a lower femoral neck shaft angle than the other groups ( p=0.007 ) . The OR ( 95 % CI ) of having a neck shaft angle of less than 134 ° , relative to the ASC group : GTR=3.33 ( 1.26 to 8.85 ) ; GTPS=1.4 ( 0.52 to 3.75 ) ; OA=0.85 ( 0.28 to 2.61 ) . The OR of GTR relative to GTPS was 2.4 ( 1.01 to 5.6 ) . No group difference was found for acetabular or greater trochanter width . Greater trochanter girth produced the only anthropometric group difference ( mean ( 95 % CI ) in cm ) GTR=103.8 ( 100.3 to 107.3 ) , GTPS=105.9 ( 100.2 to 111.6 ) , OA=100.3 ( 97.7 to 103.9 ) , ASC=99.1 ( 94.7 to 103.5 ) , ( ANOVA : p=0.036 ) . Multivariate analysis confirmed adiposity is associated with GTPS . Conclusion A lower neck shaft angle is a risk factor for , and adiposity is associated with , GTPS in women Purpose Inadequate reconstruction of femoral offset after total hip arthroplasty ( THA ) is associated with unfavourable outcomes , but its importance following hemiarthroplasty for displaced femoral neck fracture is unknown . Methods Our study examined the correlation between reconstructed femoral offset and functional outcome 12 months after  post traumatic hemiarthroplasty in 126 prospect ively enrolled elderly patients .  Rotation-corrected femoral offset ( FORC ) , relative femoral offset ( FORL ) and contralateral femoral offset ( FOC ) were measured on anteroposterior radiographs . The Harris Hip Score ( HHS ) was the primary outcome measure ; the timed up and go ( TUG ) test and Lawton instrumental activities of daily living ( IADL ) score were secondary outcomes . Correlations were sought using the Spearman correlation coefficient ( r ) . Sample size was calculated using an Altman nomogram , with the power set at 80 % , the significance level of 0.05 and a st and ardised difference of 0.75 . Results The mean reconstructed FORC was 41 mm ( 17–67 mm ) and showed a linear relationship and excellent correlation with the FOC . At 12 months , we found a significant positive correlation between FORC and HHS ( r = 0.303 , p = 0.025 ) and IADL ( r = 0.325 , p = 0.013 ) , but not TUG ( r = −0.026 , p = 0.863 ) . These findings were confirmed by bivariate and multivariate correlation between FORL and functional outcome parameters . Conclusions We found a clinical ly relevant relationship between femoral offset and functional outcome after hemiarthroplasty in elderly patients , comparable with that of THA , for treating osteoarthritis We analysed the time-dependent mean changes in the femoral neck length , neck-shaft angle and hip offset in a r and omised study comprising 48 patients who were treated with the dynamic hip screw ( DHS ) or the proximal femoral nail ( PFN ) for an unstable intertrochanteric femoral fracture . As a consequence of fracture compression , the mean post-operative neck length was significantly shorter in patients treated with the DHS . During the first 6 weeks after the operation , a mean decrease of 4.6 ° was observed in the neck-shaft angle , but there was not a significant difference between the treatment groups . The radiographic measures remained virtually unaffected during the interval from 6 weeks to 4 months in both groups . When the operated hip was compared to the opposite hip , patients who had received the DHS showed significantly greater medialisation of the femoral shaft at 4 months than those treated with the PFN . We thus recommend that unstable intertrochanteric fractures should be initially reduced in a slight valgus position in order to achieve an outcome after healing that is as normal as possible . As a result of differences in operative technique and implant stability , the PFN may be superior to the DHS in retaining the anatomical relations in the hip region in unstable intertrochanteric fractures . RésuméNous avons analysé les modifications , en fonction du temps , des valeurs moyennes de la longueur du col fémoral , de l’angle cervico-diaphysaire et du bras de levier de la hanche dans une étude r and omisée qui comprenait 48 malades traités avec une Vis Dynamique ( DHS )  ou un Clou Fémoral Proximal ( PFN ) aprés une fracture intertrochantérienne instable . Par suite de la compression de la fracture , la longueur du col était nettement plus courte chez les malades traités avec une DHS . Pendant les premières six semaines après l’opération , une baisse moyenne de 4.6 ° de l’angle cervico-diaphysaire a été observée mais il n’y avait pas de différence notable entre les groupes de traitement . Les mesures radiographiques sont restées pratiquement non affectées pendant l’intervalle de six semaines à quatre mois dans les deux groupes . Comparé à la hanche opposée , les malades qui avaient reçu une DHS ont montré à 4 mois une nettement plus gr and e médialisation de la diaphyse que ceux traités avec le PFN . Nous recomm and ons que ces fractures intertrochantériennes instables soient réduites en léger valgus pour avoir une situation aussi normale que possible après consolidation . Par suite de différences dans la technique opératoire et dans la stabilité de l’implant , le PFN semble supérieur au DHS pour rétablir l’anatomie de la région de la hanche dans les fractures intertrochantériennes instables Purpose It is crucially important to optimise functional outcome after fixation of trochanteric femoral fractures . While a number of risk factors that predict a poor clinical course have been identified , the influence of pre-existing radiographic osteoarthritis ( OA ) of the hip is unclear . Methods The influence of pre-existing radiographic OA of the hip on short- to mid-term functional outcome was prospect ively analysed in a cohort of patients undergoing proximal femoral nailing for trochanteric fracture .  OA was grade d according to Kellgren and Lawrence ; functional outcome was assessed at six and 12 months by the Harris hip score ( HHS ) , the timed up and go ( TUG ) test and the Barthel Index . Results Our cohort comprised 188 patients ( 58 were male and 130 female ) , with a mean age of 82 years . At six and 12 months postoperatively , the HHS ( p < 0.001 and p = 0.008 , respectively ) and Barthel Index ( p < 0.001 and p = 0.02 , respectively ) correlated significantly with the grade of pre-existing OA . After adjustment for confounding variables , there was a significant association between the grade of pre-existing OA and the HHS at six months ( p = 0.02 ) . Although we observed trends suggestive of other relationships , none reached statistical significance . Conclusions Pre-existing radiographic OA of the hip is an important determinant of clinical outcome in elderly patients with a trochanteric femoral fracture . Further studies will be needed to establish the most effective means of restoring hip function after trochanteric femoral fracture in patients with radiographic OA of the hip INTRODUCTION Several clinical and radiological techniques have been described to assess lower limb length and angle measurements . None of them has yet met the ideal criteria for a reliable , reproducible , safe , and inexpensive system . In this context , a new biplanar X-ray system ( EOS ™ , EOS imaging , Paris , France ) makes it possible to obtain a 3D reconstruction of the lower extremities from two 2D orthogonal radiographic images , with associated calculation of 3D measurements . The reliability of this technique has never been documented on adults . HYPOTHESIS Lower limb measurements produced by the 3D EOS ™ reconstruction system are reproducible regarding inter- and intraobserver assessment and more reliable with this 3D technique than when they are obtained from 2D measurements . MATERIAL S AND METHODS This study included 25 patients awaiting total hip arthroplasty ( 50 lower limbs ) . Two independent observers made all measurements twice , both on the 2D frontal radiograph and using 3D reconstructions ( femoral measurements of length , offset , neck shaft angle , neck length , and head diameter , as well as the tibia length , limb length , HKA and HKS ) . Reproducibility was estimated by intraclass correlation coefficients . RESULTS Both the inter- and intraobserver reproducibility of the EOS ™ measurements was excellent ; more specifically inter- and intraobserver reproducibility was 0.997 and 0.997 for femoral length , 0.996 and 0.995 for tibial length , 0.999 and 0.999 for limb length , 0.894 and 0.891 for HKS , 0.993 and 0.994 for HKA , 0.870 and 0.845 for femoral offset , and 0.765 and 0.851 for neck shaft angle . For most of the variables , the interobserver correlations were statistically better with the EOS ™ 3D reconstruction . DISCUSSION Our results show that the EOS ™ systems allow reproducible lower limb measurements . Furthermore , 3D EOS ™ reconstructions offer better reproducible measures for most of the parameters than radiographic 2D projection . Its use before deciding on surgery and during planning for lower limb arthroplasty appears essential to us . LEVEL OF EVIDENCE Level III : diagnostic prospect i ve study on consecutive patients Femoral stem version has a major influence on impingement and early post-operative stability after total hip arthroplasty ( THA ) . The main objective of this study was to evaluate the validity of a novel radiological method for measuring stem version .  Anteroposterior ( AP ) radiographs and three-dimensional CT scans were obtained for 115 patients ( female/male 63/72 , mean age 62.5 years ( 50 to 75 ) ) who had undergone minimally invasive , cementless THA .  Stem version  was calculated from the AP hip radiograph by rotation-based change in the projected prosthetic neck-shaft ( NSA * ) angle using the mathematical formula ST = arcos [ tan ( NSA * ) / tan ( 135 ) ] . We used two independent observers who repeated the analysis after a six-week interval . Radiological measurements were compared with 3D-CT measurements by an independent , blinded external institute . We found a mean difference of 1.2 ° ( sd 6.2 ) between radiological and 3D-CT measurements of stem version . The correlation between the mean radiological and 3D-CT stem torsion was r = 0.88 ( p < 0.001 ) . The intra- ( intraclass correlation coefficient ≥ 0.94 ) and inter-observer agreement ( mean concordance correlation coefficient = 0.87 ) for the radiological measurements were excellent . We found that femoral tilt was associated with the mean radiological measurement error ( r = 0.22 , p = 0.02 ) . The projected neck-shaft angle is a reliable method for measuring stem version on AP radiographs of the hip after a THA . However , a highly st and ardised radiological technique is required for its precise measurement BACKGROUND Increased femoral anteversion and coxa valga are common in patients with cerebral palsy . The purpose of the present study was to determine the validity and reliability of the methods that are commonly used to measure the proximal femoral geometry in patients with cerebral palsy . METHODS Thirty-six consecutive patients ( mean age , eleven years ; range , five to twenty years ) with cerebral palsy were enrolled in the present study . The validity and the interobserver reliability of the physical examinations performed by three examiners were determined by comparing the results of a trochanteric prominence angle test , hip internal rotation measurements , and  hip external rotation measurements  ( all with the patient in the prone position ) with the amount of femoral anteversion on two-dimensional computed tomography .  Validity and intraobserver and interobserver reliability were assessed by comparing the neck-shaft angle on the anteroposterior internal rotation radiograph of the hips with that on the multiplanar reformatted computed tomographic image . RESULTS The trochanteric prominence angle test showed excellent concurrent validity ( R = 0.862 , p < 0.001 ) and reliability ( intraclass correlation coefficient , 0.809 ) . Hip internal rotation also showed good concurrent validity ( R = 0.787 , p < 0.001 ) and excellent 
    Output:
    
The reported effect of rotation-correction can not be reliably verified