Chen Chun-Ming, Lin Shang-Chih, Wu Chen-Te, Chan Yi-Sheng
Taiwan High Speed 3D Printing Research Center, National Taiwan University of Science and Technology, No. 43, Sec. 4, Keelung Rd., Da'an Dist., Taipei, Taiwan.
Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, No. 43, Sec. 4, Keelung Rd., Da'an Dist., Taipei, Taiwan.
J Hip Preserv Surg. 2023 Nov 11;11(1):20-29. doi: 10.1093/jhps/hnad037. eCollection 2024 Jan.
Image-based criteria have been adopted to diagnose femoroacetabular impingement (FAI). However, the overlapping property of the two-dimensional X-ray outlines and static and supine posture of taking computed tomography (CT) and magnetic resonance imaging images potentially affect the accuracy of the criteria. This study developed a CT image-based dynamic criterion to effectively simulate FAI, thereby providing a basis for physicians to perform pre-operative planning for arthroscopic surgery. Post-operative CT images of 20 patients with satisfactory surgical results were collected, and 10 sets of models were used to define the flexion rotation centre (FRC) of the three-dimensional FAI model. First, let these 10 groups of models simulate the FAI detection action and find the best centre offset, and then FRC is the result of averaging these 10 groups of best displacements. The model was validated in 10 additional patients. Finally, through the adjustment basis of FRC, the remaining 10 sets of models can find out the potential position of FAI during the dynamic simulation process. Rotational collisions detected using FRC indicate that the patient's post-operative flexion angle may reach 120° or greater, which is close to the actual result. The recommended surgical range of the diagnostic system (average length of 6.4 mm, width of 4.1 mm and depth of 3.2 mm) is smaller than the actual surgical results, which prevents the doctor from performing excessive resection operations, which may preserve more bones. The FRC diagnostic system detects the distribution of FAI in a simple manner. It can be used as a pre-operative diagnosis reference for clinicians, hoping to improve the effect and accuracy of debridement surgery.
基于图像的标准已被用于诊断股骨髋臼撞击症（FAI）。然而，二维X射线轮廓的重叠特性以及计算机断层扫描（CT）和磁共振成像图像采集时的静态仰卧姿势可能会影响标准的准确性。本研究开发了一种基于CT图像的动态标准，以有效模拟FAI，从而为医生进行关节镜手术的术前规划提供依据。收集了20例手术结果满意患者的术后CT图像，并使用10组模型来定义三维FAI模型的屈曲旋转中心（FRC）。首先，让这10组模型模拟FAI检测动作并找到最佳中心偏移量，然后FRC是这10组最佳位移量的平均值。该模型在另外10例患者中进行了验证。最后，通过FRC的调整基础，其余10组模型可以在动态模拟过程中找出FAI的潜在位置。使用FRC检测到的旋转碰撞表明患者术后屈曲角度可能达到120°或更大，这与实际结果接近。诊断系统推荐的手术范围（平均长度6.4毫米、宽度4.1毫米和深度3.2毫米）小于实际手术结果，这可防止医生进行过度切除手术，从而可能保留更多骨质。FRC诊断系统以简单的方式检测FAI的分布情况。它可作为临床医生术前诊断的参考，希望能提高清创手术的效果和准确性。
