Lee Tae Sung, Kwon Hyuck Min, Park Jun Young, Kim Dong Ki, Kang Kyoung Tak, Park Kwan Kyu
Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.
Department of Mechanical Engineering, Yonsei University, Seoul 03722, Republic of Korea.
J Clin Med. 2023 Oct 21;12(20):6664. doi: 10.3390/jcm12206664.
A postoperative radiograph in total hip arthroplasty (THA) is usually obtained to evaluate the inclination and anteversion of the acetabular components. However, there is no gold-standard method for calculating the exact inclination and anteversion of the acetabular components on post-THA radiographs. We aimed to measure the actual anteversion of the acetabular component on postoperative radiographs by obtaining correlation data between the virtual and actual acetabular component positioning using virtual three-dimensional (3D) surgery.
A total of 64 hip scans of 32 patients who underwent lower-extremity computed tomography (CT) were retrospectively reviewed. We reconstructed 3D models of the 64 hips using customized computer software (Mimics). Furthermore, to identify the safe zone of acetabular component position in THA, we performed virtual 3D surgery simulations for five anteversion (-10°, 0°, 10°, 20°, and 30°) and five inclination (20°, 30°, 40°, 50°, and 60°) types. We analyzed the acetabular anatomy using 3D models to measure the radiographic, anatomical, and operative anteversion (RA, AA, OA) and inclination (RI, AI, OI) angles. Additionally, we used the Woo-Morrey (WM) method to calculate the anteversion angle in the reconstructed cross-table lateral (CL) radiographs and determined the correlation between these measurements.
The safe zone of the acetabular component was visualized on post-THA CL radiographs using the WM method of anteversion measurement based on the different anteversions and inclinations of the acetabular component. The AA, RA, OA, OI, and WM differed significantly between males and females ( value < 0.05). As the anatomical inclination or anteversion increased, the WM anteversion measurements also increased. The radiographic anteversion measurement best matched the WM method of measurement, followed by anatomical and operative methods.
The actual anteversion of the acetabular component after THA can be measured on CL radiographs with the WM method using a 3D virtual program, with good reproducibility.
全髋关节置换术（THA）术后通常会拍摄X线片以评估髋臼组件的倾斜度和前倾角。然而，在THA术后X线片上计算髋臼组件的确切倾斜度和前倾角尚无金标准方法。我们旨在通过使用虚拟三维（3D）手术获取虚拟与实际髋臼组件定位之间的相关数据，来测量术后X线片上髋臼组件的实际前倾角。
回顾性分析32例行下肢计算机断层扫描（CT）患者的64例髋关节扫描数据。我们使用定制的计算机软件（Mimics）重建了64个髋关节的3D模型。此外，为确定THA中髋臼组件位置的安全区，我们对五种前倾角（-10°、0°、10°、20°和30°）和五种倾斜度（20°、30°、40°、50°和60°）类型进行了虚拟3D手术模拟。我们使用3D模型分析髋臼解剖结构，以测量X线、解剖和手术前倾角（RA、AA、OA）以及倾斜度（RI、AI、OI）角度。此外，我们使用Woo-Morrey（WM）方法计算重建的交叉台侧位（CL）X线片中的前倾角，并确定这些测量值之间的相关性。
基于髋臼组件的不同前倾角和倾斜度，使用WM前倾角测量方法在THA术后CL X线片上可显示髋臼组件的安全区。男性和女性之间的AA、RA、OA、OI和WM存在显著差异（ 值<0.05）。随着解剖倾斜度或前倾角增加，WM前倾角测量值也增加。X线前倾角测量与WM测量方法最匹配，其次是解剖和手术方法。
THA术后髋臼组件的实际前倾角可使用3D虚拟程序通过WM方法在CL X线片上进行测量，具有良好的可重复性。
