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基于中国人群髋关节旋转中心和股骨偏心距三维CT图像重建的解剖学研究:全髋关节置换术前的意义

Anatomical study based on 3D-CT image reconstruction of the hip rotation center and femoral offset in a Chinese population: preoperative implications in total hip arthroplasty.

作者信息

Yi Lin-Hong, Li Rui, Zhu Zheng-Ya, Bai Chao-Wen, Tang Jin-Long, Zhao Feng-Chao, Zheng Xin, Guo Kai-Jin

机构信息

Department of Orthopaedics, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.

Department of Medical Imaging, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.

出版信息

Surg Radiol Anat. 2019 Jan;41(1):117-124. doi: 10.1007/s00276-018-2143-9. Epub 2018 Nov 28.

Abstract

BACKGROUND

Several anatomical studies regarding the value of hip rotation center (HRC) and femoral offset (FO) have been performed in Western populations. However, there are a few data on hip morphological values in the Chinese population based on CT scans. This study measured the values of the hip and pelvis, especially HRC and FO, in a Chinese population and compared them with the published values obtained from Western populations.

PATIENTS AND METHODS

One hundred patients (50 females and 50 males) were included in the present study, and 3D-CT reconstructions of the hip and pelvis were generated. The mean age was 51.4 ± 8.9 years and mean body mass index (BMI) was 23.5 ± 2.6 kg/m. All the morphologic measurements were compared between genders and sides, and the relationships between different parameters were analyzed.

RESULTS

The mean FO values were 38.4 ± 4.7 mm and 35.6 ± 4.4 mm for the males and females, respectively. A significant negative correlation was noted between FO and neck shaft angle (NSA) in both genders (r = - 0.262, P = 0.009 for the males, r = - 0.350, P ≤ 0.001 for the females). A significant positive correlation was found between horizontal distance (HD) and diameter of the femoral head (DFH) in both genders (r = 0.734, P ≤ 0.001 for the males, r = 0.658, P ≤ 0.001 for the females). A significant positive correlation was noted between HD and pelvic width (PW) in males (r = 0.455, P ≤ 0.001). A significant positive correlation was also noted between HD and pelvic height (PH) in males (r = 0.318, P ≤ 0.001). A significant positive correlation was observed between FO and pelvic cavity height (PCH) in males (r = 0.411, P ≤ 0.001), and a significant positive correlation was observed between VD and PCH in females (r = 0.497, P ≤ 0.001). The tip of the greater trochanter was, on average, 7.0 mm higher than the femoral head center. Relationships between DFH and pelvic morphometric parameters were also observed.

CONCLUSION

The present morphological data and the relationships between them can be applied to design better ethnic-specific THA prostheses and preoperative plans.

摘要

背景

西方人群已经开展了多项关于髋关节旋转中心(HRC)和股骨偏心距(FO)价值的解剖学研究。然而,基于CT扫描的中国人群髋关节形态学数据较少。本研究测量了中国人群的髋关节和骨盆参数,尤其是HRC和FO,并将其与西方人群已发表的数据进行比较。

患者与方法

本研究纳入了100例患者(50例女性和50例男性),并生成了髋关节和骨盆的三维CT重建图像。平均年龄为51.4±8.9岁,平均体重指数(BMI)为23.5±2.6kg/m²。比较了所有形态学测量值在性别和左右侧之间的差异,并分析了不同参数之间的关系。

结果

男性和女性的平均FO值分别为38.4±4.7mm和35.6±4.4mm。男女两性的FO与颈干角(NSA)之间均存在显著负相关(男性:r=-0.262,P=0.009;女性:r=-0.350,P≤0.001)。男女两性的水平距离(HD)与股骨头直径(DFH)之间均存在显著正相关(男性:r=0.734,P≤0.001;女性:r=0.658,P≤0.001)。男性的HD与骨盆宽度(PW)之间存在显著正相关(r=0.455,P≤0.001)。男性的HD与骨盆高度(PH)之间也存在显著正相关(r=0.318,P≤0.001)。男性的FO与盆腔高度(PCH)之间存在显著正相关(r=0.411,P≤0.001),女性的垂直距离(VD)与PCH之间存在显著正相关(r=0.497,P≤0.001)。大转子尖端平均比股骨头中心高7.0mm。还观察到了DFH与骨盆形态学参数之间的关系。

结论

目前的形态学数据及其之间的关系可应用于设计更适合特定种族的全髋关节置换术(THA)假体和术前计划。

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