Department of Orthopaedic and Trauma Surgery, University Hospital Heidelberg, Schlierbacher Landstr. 200 A 69118, Heidelberg, Germany; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
J Orthop Res. 2014 Mar;32(3):413-22. doi: 10.1002/jor.22518. Epub 2013 Nov 19.
We assessed the variation in proximal femoral canal shape and its association with geometric and demographic parameters in primary hip OA. In a retrospective cohort study, the joint geometry of the proximal femur was evaluated on radiographs and corresponding CT scans of 345 consecutive patients with end-stage hip OA. Active shape modeling (ASM) was performed to assess the variation in endosteal shape of the proximal femur. To identify natural groupings of patients, hierarchical cluster analysis of the shape modes was used. ASM identified 10 independent shape modes accounting for >96% of the variation in proximal femoral canal shape within the dataset. Cluster analysis revealed 10 specific shape clusters. Significant differences in geometric and demographic parameters between the clusters were observed. ASM and subsequent cluster analysis have the potential to identify specific morphological patterns of the proximal femur despite the variability in proximal femoral anatomy. The study identified patterns of proximal femoral canal shape in hip OA that allow a comprehensive classification of variation in shape and its association with joint geometry. Our data may improve future stem designs that will optimize stem fit and simultaneously allow individual restoration of hip biomechanics.
我们评估了原发性髋关节骨关节炎中股骨近端管腔形状的变化及其与几何和人口统计学参数的关系。在一项回顾性队列研究中，对 345 例终末期髋关节骨关节炎患者的关节进行了影像学和相应 CT 扫描，评估了股骨近端的关节几何形状。采用主动形状建模（ASM）来评估股骨近端的骨内膜形状变化。为了确定患者的自然分组，对形状模式进行了层次聚类分析。ASM 确定了 10 个独立的形状模式，占数据集内股骨近端管腔形状变化的>96%。聚类分析显示了 10 个特定的形状簇。在聚类之间观察到几何和人口统计学参数的显著差异。ASM 和随后的聚类分析有可能识别股骨近端的特定形态模式，尽管股骨近端解剖结构存在变异性。该研究确定了髋关节骨关节炎中股骨近端管腔形状的模式，从而能够全面分类形状的变化及其与关节几何形状的关系。我们的数据可能会改进未来的干设计，从而优化干的拟合，并同时允许对髋关节生物力学进行个体化恢复。
