Richolt J A, Teschner M, Everett P C, Millis M B, Kikinis R
Orthopädische Universitätsklinik, Stiftung Friedrichsheim, Frankfurt, Germany.
Comput Aided Surg. 1999;4(3):144-51. doi: 10.1002/(SICI)1097-0150(1999)4:3<144::AID-IGS3>3.0.CO;2-S.
Affecting as it does the geometry of adolescent hips, slipped capital femoral epiphysis (SCFE) and its evaluation represent a major three-dimensional problem. The current methods of clinical assessment-geometric measurements of the femur on plain radiographs or on axial computed tomographic (CT) cross-sections-address only one of the two joint components.
We have developed a system to simulate motion of hip joints with physiologic joint contact. In our system, CT-based computer models of the femur, pelvis, etc., are fitted with oriented bounding boxes (OBBs) and manipulated. Collision detection algorithms control the hip motion, which, in this virtual joint, is based on the surface geometry of the joint partners rather than on a predefined fixed rotation center.
An illustrative case is presented to show the advantages of the new biomechanical evaluation method over conventional radiological assessments for SCFE. The proposed system provides remarkably high speed, and the necessary data can be prepared in a reasonable time.
The range-of-motion assessment provides the surgeon with information about the site and the impact of nonphysiologic contact in the hip joint. The information thus obtained can be valuable for indication and planning of corrective surgery in cases of SCFE.
由于股骨头骨骺滑脱(SCFE)会影响青少年髋关节的几何形态,其评估是一个重大的三维问题。目前的临床评估方法——通过普通X线片或轴向计算机断层扫描(CT)横断面进行股骨的几何测量——仅涉及两个关节组成部分中的一个。
我们开发了一种系统,用于模拟具有生理性关节接触的髋关节运动。在我们的系统中,基于CT的股骨、骨盆等计算机模型配备有定向包围盒(OBB)并进行操作。碰撞检测算法控制髋关节运动,在这个虚拟关节中,运动基于关节伙伴的表面几何形状,而不是基于预定义的固定旋转中心。
通过一个示例病例展示了这种新的生物力学评估方法相对于传统放射学评估方法在SCFE方面的优势。所提出的系统速度非常快,并且可以在合理的时间内准备好所需数据。
运动范围评估为外科医生提供了有关髋关节非生理性接触部位及其影响的信息。由此获得的信息对于SCFE病例的手术指征和矫正手术规划可能具有重要价值。