Shoji Takeshi, Yasunaga Yuji, Yamasaki Takuma, Izumi Soutarou, Adachi Nobuo, Ochi Mitsuo
Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
Department of Orthopaedic Surgery, Hiroshima Prefectural Rehabilitation Center, Higashihiroshima, Japan.
J Arthroplasty. 2016 Sep;31(9):2058-63. doi: 10.1016/j.arth.2016.02.018. Epub 2016 Feb 17.
Despite the fact that femoral impingement against the anterior inferior iliac spine (AIIS) is increasingly recognized, there is no description of morphologic features of the AIIS in hip dysplasia and their effect on hip range of motion (ROM) in total hip arthroplasty (THA). The purpose is to evaluate the bone morphology of the AIIS in hip dysplasia and whether its morphology affects hip ROM in THA.
Computed tomography-based simulation software was used to create 3-dimensional bone models and perform virtual simulations. Using the computed tomographic data of 85 patients (male: n = 25, female: n = 60, mean age: 60.9) with hip osteoarthritis due to dysplasia, we measured the straight, vertical, and horizontal distances between the anteroinferior edge of the AIIS and the center of rotation in sagittal and axial views. The anterior and lateral versions of the AIIS were also measured. We calculated the ROM of flexion (Flex), and internal rotation (Int-R) in THA in the software, and analyzed the correlations among them.
The AIIS prominence is bigger and extends more anteriorly and laterally in males than in females. Furthermore, the taller the patient, the more the AIIS extends anteriorly and laterally. We found that Flex and Int-R decreased inversely proportional to the size and lateral version of the AIIS.
Our results demonstrated that the AIIS bone morphology substantially affects the ROM of Flex and Int-R especially in patients with laterally large AIIS bony anatomy in THA. Furthermore, our result indicates that the morphologic features of AIIS in hip dysplasia may be different between males and females.
尽管股骨与髂前下棘(AIIS)撞击的情况越来越受到关注,但目前尚无关于髋关节发育不良中AIIS形态特征及其对全髋关节置换术(THA)中髋关节活动范围(ROM)影响的描述。本研究旨在评估髋关节发育不良中AIIS的骨形态,以及其形态是否会影响THA中的髋关节ROM。
使用基于计算机断层扫描的模拟软件创建三维骨模型并进行虚拟模拟。利用85例因发育不良导致髋关节骨关节炎患者(男性:n = 25,女性:n = 60,平均年龄:60.9岁)的计算机断层扫描数据,我们在矢状面和轴位视图中测量了AIIS前下缘与旋转中心之间的直线、垂直和水平距离。还测量了AIIS的前倾角和外侧角。我们在软件中计算了THA中屈曲(Flex)和内旋(Int-R)的ROM,并分析了它们之间的相关性。
男性的AIIS突出度比女性更大,且在前方和外侧的延伸更多。此外,患者身高越高,AIIS在前方和外侧的延伸越多。我们发现Flex和Int-R与AIIS的大小和外侧角成反比降低。
我们的结果表明,AIIS的骨形态对Flex和Int-R的ROM有显著影响,特别是在THA中具有外侧大AIIS骨解剖结构的患者中。此外,我们的结果表明,髋关节发育不良中AIIS的形态特征在男性和女性之间可能有所不同。