Ji Wen-Ting, Tao Kai, Wang Cheng-Tao
Institute of Biomedical Manufacturing and Life Quality Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai, China.
Clin Biomech (Bristol). 2010 Jun;25(5):427-32. doi: 10.1016/j.clinbiomech.2010.01.012. Epub 2010 Mar 1.
Proper option and optimal alignment of implants are major factors in obtaining the desired range of motion of total hip arthroplasty. It would be very useful if a tool is available to assist clinicians to preoperatively determine proper implants and their optimal intraoperative alignment for individual patient.
Based on the secondary development function of ADAMS/VIEW, a three-dimensional parameterized module was developed to simulate six motions of implants for total hip arthroplasty. Total eight parameters (stem abduction, acetabular size, head size, general head-neck ratio, stem-neck angle, acetabular anteversion, acetabular inclination and femoral antetorsion) were included and three definitions of acetabular orientations (operative, radiographic and anatomical) were available. Any initial position of implants and simulation precision could be defined on the demand.
After entering these eight parameters, a special model of total hip arthroplasty would be constructed. Single or combined motion until the prosthetic impingement could be simulated visually and the corresponding maximal rotation angle would be quantified.
Clinical factors, such as patients with severe deformity of hip joint or a large range of motion demand, should be considered during total hip arthroplasty. This module can provide references for clinicians on proper option and intraoperative implantation of components, and be suitable for postoperative evaluation. Furthermore, it is a tool to investigate the "safe-zones" of total hip arthroplasty and also can be employed for the design of new implant system.
植入物的正确选择和最佳对线是实现全髋关节置换术理想活动范围的主要因素。如果有一种工具能够帮助临床医生在术前为个体患者确定合适的植入物及其术中最佳对线，那将非常有用。
基于ADAMS/VIEW的二次开发功能，开发了一个三维参数化模块，以模拟全髋关节置换术中植入物的六种运动。总共包括八个参数（柄外展、髋臼尺寸、股骨头尺寸、一般头颈比、柄颈角度、髋臼前倾角、髋臼倾斜度和股骨扭转角），并且有三种髋臼方向的定义（手术、影像学和解剖学）可供使用。可以根据需要定义植入物的任何初始位置和模拟精度。
输入这八个参数后，将构建一个特殊的全髋关节置换模型。可以直观地模拟单个或组合运动直至假体撞击，并对相应的最大旋转角度进行量化。
在全髋关节置换术中应考虑临床因素，如髋关节严重畸形或活动范围需求大的患者。该模块可为临床医生在组件的正确选择和术中植入方面提供参考，适用于术后评估。此外，它是一种研究全髋关节置换术“安全区”的工具，也可用于新植入系统的设计。
