Division of Rehabilitation, Hitsujigaoka Hospital, Sapporo, Japan.
Department of Health Sciences, Hokkaido Chitose Collage of Rehabilitation, Chitose, Japan.
PLoS One. 2024 Jun 3;19(6):e0300938. doi: 10.1371/journal.pone.0300938. eCollection 2024.
To clarify the morphological factors of the pelvis in patients with developmental dysplasia of the hip (DDH), three-dimensional (3D) pelvic morphology was analyzed using a template-fitting technique.
Three-dimensional pelvic data of 50 patients with DDH (DDH group) and 3D pelvic data of 50 patients without obvious pelvic deformity (Normal group) were used. All patients were female. A template model was created by averaging the normal pelvises into a symmetrical and isotropic mesh. Next, 100 homologous models were generated by fitting the pelvic data of each group of patients to the template model. Principal component analysis was performed on the coordinates of each vertex (15,235 vertices) of the pelvic homologous model. In addition, a receiver-operating characteristic (ROC) curve was calculated from the sensitivity of DDH positivity for each principal component, and principal components for which the area under the curve was significantly large were extracted (p<0.05). Finally, which components of the pelvic morphology frequently seen in DDH patients are related to these extracted principal components was evaluated.
The first, third, and sixth principal components showed significantly larger areas under the ROC curves. The morphology indicated by the first principal component was associated with a decrease in coxal inclination in both the coronal and horizontal planes. The third principal component was related to the sacral inclination in the sagittal plane. The sixth principal component was associated with narrowing of the superior part of the pelvis.
The most important factor in the difference between normal and DDH pelvises was the change in the coxal angle in both the coronal and horizontal planes. That is, in the anterior and superior views, the normal pelvis is a triangle, whereas in DDH, it was more like a quadrilateral.
为了阐明发育性髋关节发育不良（DDH）患者骨盆的形态学因素，采用模板拟合技术对三维（3D）骨盆形态进行了分析。
使用 50 例 DDH 患者（DDH 组）和 3D 骨盆数据无明显骨盆畸形的 50 例患者（正常组）的三维骨盆数据。所有患者均为女性。通过将正常骨盆平均化为对称各向同性网格来创建模板模型。接下来，通过将每组患者的骨盆数据拟合到模板模型，生成 100 个同源模型。对骨盆同源模型每个顶点（15235 个顶点）的坐标进行主成分分析。此外，根据每个主成分对 DDH 阳性的敏感度计算接收者操作特征（ROC）曲线，并提取曲线下面积显著较大的主成分（p<0.05）。最后，评估与这些提取的主成分相关的 DDH 患者骨盆形态中经常出现的哪些成分。
第一、第三和第六主成分的 ROC 曲线下面积显著较大。第一主成分指示的形态与冠状面和水平面中骨盆倾斜度降低有关。第三主成分与矢状面中骶骨倾斜度有关。第六主成分与骨盆上部变窄有关。
正常和 DDH 骨盆之间差异的最重要因素是骨盆在冠状面和水平面中的角度变化。也就是说，在前后上方视图中，正常骨盆为三角形，而在 DDH 中，更像是四边形。
