前中心边缘角在预测发育性髋关节发育不良患者行髋臼周围截骨术后股骨头的三维覆盖范围方面能力有限。
The anterior center edge angle has limited ability to predict three-dimensional coverage of the femoral head in patients with developmental dysplasia of the hip undergoing curved periacetabular osteotomy.
机构信息
Department of Orthopaedics, University of Utah, 590 Wakara Way Rm A100, Salt Lake City, UT, 84108, USA.
Niigata Hip Joint Center, Kameda Daiichi Hospital, Niigata City, Niigata, 9500165, Japan.
出版信息
Arch Orthop Trauma Surg. 2023 Mar;143(3):1323-1330. doi: 10.1007/s00402-021-04258-4. Epub 2022 Jan 3.
INTRODUCTION
Femoral head coverage in patients with hip dysplasia (DDH) is typically quantified using 2D measurements of the lateral center edge angle (LCEA) and anterior center edge angle (ACEA). However, as the morphology of DDH is complex and varies between patients, 2D measurements may not predict the true 3D femoral head coverage. Herein, 2D and 3D coverage were quantified before and after curved periacetabular osteotomy (CPO) and their relationships were assessed.
MATERIALS AND METHODS
Forty-three hips that underwent CPO for DDH were analyzed. For 2D evaluation, LCEA was quantified from X-rays and CT images. The ACEA was measured from CT images (CT-ACEA) and digitally reconstructed radiographs generated from CT images (DRR-ACEA). Three-dimensional coverage was quantified from CT reconstructions of the hip and evaluated in the anterior, superior, posterior, and inferior regions of the femoral head. Two-dimensional measurements were correlated to 3D coverage to assess their relationships.
RESULTS
The median preoperative 3D percent coverage was 17.7, 36.1, 56.1, and 14.6% for the anterior, superior, posterior, and inferior region, respectively. After CPO, all LCEAs and ACEAs increased significantly (all p < 0.001). For the 3D coverage, anterior and superior coverage significantly increased while the posterior and inferior coverage decreased (all p < 0.001). Moderate to strong correlations were detected between the two LCEAs and the 3D superior coverage in both the preoperative and postoperative period. For the correlation between 3D anterior coverage, no significant correlation was found between the CT-ACEA while a moderate correlation was found between the DRR-ACEA (r = 0.41, p = 0.023).
CONCLUSIONS
Our results indicate that the LCEA can be used to predict 3D coverage in the superior region of the femoral head. However, as the CT-ACEA or DRR-ACEA had no or only moderate correlation between the 3D anterior coverage, these measurements are not recommended for evaluating/estimating the 3D anterior coverage in patients with DDH.
简介
在发育性髋关节发育不良（DDH）患者中，股骨头覆盖通常通过测量外侧中心边缘角（LCEA）和前侧中心边缘角（ACEA）的二维测量来定量。然而，由于 DDH 的形态复杂，且在患者之间存在差异，二维测量可能无法预测真实的 3D 股骨头覆盖。本文定量评估了 DDH 患者行髋臼曲形截骨术（CPO）前后的 2D 和 3D 覆盖，并评估了两者之间的关系。
材料和方法
对 43 例行 CPO 治疗的 DDH 患者的髋关节进行分析。2D 评估中，X 线片和 CT 图像均用于测量 LCEA。CT 图像（CT-ACEA）和从 CT 图像重建的数字重建射线照片（DRR-ACEA）均可测量 ACEA。3D 覆盖通过髋关节 CT 重建进行定量，并评估股骨头上部、前侧、后侧和下部区域。将二维测量值与 3D 覆盖值进行相关性分析，以评估它们之间的关系。
结果
术前 3D 百分比覆盖中位数分别为：前侧 17.7%、上部 36.1%、后侧 56.1%和下部 14.6%。CPO 术后，所有 LCEA 和 ACEA 均显著增加（均 P<0.001）。3D 覆盖中，前侧和上部覆盖明显增加，而后侧和下部覆盖减少（均 P<0.001）。术前和术后，LCEA 与 3D 上部覆盖之间均存在中到高度的相关性。而对于 3D 前侧覆盖，CT-ACEA 之间无显著相关性，而 DRR-ACEA 之间存在中度相关性（r=0.41，P=0.023）。
结论
我们的研究结果表明，LCEA 可用于预测股骨头上部的 3D 覆盖。然而，由于 CT-ACEA 或 DRR-ACEA 与 3D 前侧覆盖之间无相关性或仅有中度相关性，因此不建议在 DDH 患者中使用这些测量值来评估/估计 3D 前侧覆盖。
Zotero 插件