Alter Thomas D, Malloy Philip, Newhouse Alex C, Suppauksorn Sunikom, Orias Alejandro Espinzoa, Chahla Jorge, Inoue Nozomu, Nho Shane J
Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Hip Preservation Center, Rush University, Chicago, Illinois.
Department of Physical Therapy, Arcadia University, Pennsylvania, U.S.A.
Arthrosc Sports Med Rehabil. 2021 Sep 27;3(6):e1857-e1863. doi: 10.1016/j.asmr.2021.08.016. eCollection 2021 Dec.
To determine whether 3-dimensional (3D)-reconstructed proximal femoral bone models can be used to quantify femoral osteochondroplasty and to determine whether the 3D-based metrics are related to clinical alpha angle measures.
Six cadaveric specimens with cam-type morphology underwent open femoral osteochondroplasty. Alpha angles were measured on the oblique axial computed tomography slice before and after femoral osteochondroplasty. Preoperative and postoperative computed tomography-based 3D reconstructed femur models were generated for each cadaveric specimen. A 3D-3D registration technique was used to merge the preoperative and postoperative models to measure the surface-to-surface distance between the model surfaces. Bivariate correlation analyses were used to determine the correlations between the preoperative, and the difference between the preoperative and postoperative alpha angle (Δ alpha angle) measures and each of the femoral osteochondroplasty variables of surface area (mm), volume (mm), maximum height (mm), and mean height (mm). The strength of the bivariate correlations was defined as follows: weak 0.1 to 0.3, moderate 0.3 to 0.5, and strong as 0.5 to 1.00.
Bivariate correlations revealed a strong positive correlation between preoperative alpha angle with femoral osteochondroplasty volume (r = 0.899, = .007) and surface area (r = 0.899, = .007). No significant correlations were found between the change in alpha angle and the osteochondroplasty variables.
In this study, pre- and postoperative 3D bone models could be used to quantify femoral osteochondroplasty and to determine if the 3D-based metrics are related to clinical alpha angle measures.
3D-reconstructed image bone models may be helpful to ensure that adequate femoroplasty is performed intraoperatively, in particular with arthroscopic approach in which visualization may be challenging due to capsular management issues and surgeon experience.
确定三维（3D）重建的股骨近端骨模型是否可用于量化股骨骨软骨成形术，并确定基于3D的指标是否与临床α角测量值相关。
对6个具有凸轮型形态的尸体标本进行开放性股骨骨软骨成形术。在股骨骨软骨成形术前和术后，在斜轴计算机断层扫描切片上测量α角。为每个尸体标本生成术前和术后基于计算机断层扫描的3D重建股骨模型。使用3D-3D配准技术合并术前和术后模型，以测量模型表面之间的表面到表面距离。采用双变量相关性分析来确定术前、术前与术后α角差值（Δα角）测量值与股骨骨软骨成形术各变量（表面积（mm）、体积（mm）、最大高度（mm）和平均高度（mm））之间的相关性。双变量相关性的强度定义如下：弱相关为0.1至0.3，中度相关为0.3至0.5，强相关为0.5至1.00。
双变量相关性分析显示，术前α角与股骨骨软骨成形术体积（r = 0.899，P = 0.007）和表面积（r = 0.899，P = 0.007）之间存在强正相关。未发现α角变化与骨软骨成形术变量之间存在显著相关性。
在本研究中，术前和术后的3D骨模型可用于量化股骨骨软骨成形术，并确定基于3D的指标是否与临床α角测量值相关。
3D重建的图像骨模型可能有助于确保术中进行充分的股骨成形术，特别是在关节镜手术中，由于关节囊管理问题和外科医生经验，可视化可能具有挑战性。
