Mahieu Peter, Hananouchi Takehito, Watanabe Nobuyuki, Claes Peter, Li Hao, Audenaert Emmanuel
Acta Orthop Belg. 2018 Sep;84(3):307-315.
To apply cutting edge geometry processing techniques and statistical shape modelling to perform a quali-tative and quantitive evaluation of femoral deformity in developmental hip dysplasia and to describe its relation to the amount of acetabular coverage in full 3D. An observational case-control study consisting of 40 right dysplastic cases compared to 43 normal hips, was designed. All subjects were Asian females with an average age of 53.9 years. The right femurs were scanned using computed tomography, followed by 3D reconstruction for statistical shape modelling. Inter- shape correspondences of the femoral shape were used to portray changes in femoral morphology to the amount of acetabular coverage. Partial least-squares regression was applied to establish a direct connection between acetabular coverage and the geometry of the femoral shape. Acetabular coverage accounted for 7.1% of variation in the overal femur shape (p<0.05). Significant changes in femoral morphology (p<0.05) were observed with decreasing acetabular coverage. The regression model demonstrated progressive shortening of the femur neck, as well as increasing attening of the femur head. Further, analysis of curvature and normal displacement demonstrated significant (p<0.05) flat- tening of the femur head especially in the area of the head-neck junction with increasing severity of acetabular dysplasia. Anatomic abnormalities inherent to the dysplastic hip are limited to the very proximal part of the femur and significantly increase when the acetabular coverage decreases. Flattening of the femur head is most pronounced at the peripheral part of the head, in specific the femoral head-neck region.
应用前沿的几何处理技术和统计形状建模，对发育性髋关节发育不良中的股骨畸形进行定性和定量评估，并在全三维空间中描述其与髋臼覆盖量的关系。设计了一项观察性病例对照研究，包括40例右侧发育不良病例与43例正常髋关节进行对比。所有受试者均为亚洲女性，平均年龄53.9岁。使用计算机断层扫描对右侧股骨进行扫描，随后进行三维重建以进行统计形状建模。利用股骨形状的形状间对应关系来描绘股骨形态随髋臼覆盖量的变化。应用偏最小二乘回归来建立髋臼覆盖与股骨形状几何之间的直接联系。髋臼覆盖占整个股骨形状变异的7.1%（p<0.05）。随着髋臼覆盖量减少，观察到股骨形态有显著变化（p<0.05）。回归模型显示股骨颈逐渐缩短，以及股骨头变平加剧。此外，曲率和法向位移分析表明，随着髋臼发育不良严重程度增加，股骨头明显变平（p<0.05），尤其是在头颈交界处区域。发育性髋关节发育不良固有的解剖异常仅限于股骨非常近端的部分，并且当髋臼覆盖量减少时显著增加。股骨头变平在股骨头周边部分最为明显，特别是在股骨头-颈区域。
