背景:通常获得全髋关节置换术(THA)的术后X光片,以评估髋臼组件的倾斜和前倾。然而,在THA后的射线照片上,没有黄金标准的方法来计算髋臼组件的确切倾斜和前倾。我们旨在通过使用虚拟三维(3D)手术获得虚拟和实际髋臼成分定位之间的相关性数据,来测量术后X线照片上髋臼成分的实际前倾。
方法:回顾性分析了32例接受下肢计算机断层扫描(CT)的患者的64例髋部扫描。我们使用定制的计算机软件(Mimics)重建了64个臀部的3D模型。此外,为了确定THA中髋臼成分位置的安全区,我们对五个前倾进行了虚拟3D手术模拟(-10°,0°,10°,20°,和30°)和五个倾斜度(20°,30°,40°,50°,和60°)类型。我们使用3D模型分析髋臼解剖结构,解剖学,和手术前倾(RA,AA,OA)和倾斜度(RI,AI,OI)角度。此外,我们使用Woo-Morrey(WM)方法计算了重建的横表横向(CL)射线照片中的前倾角,并确定了这些测量之间的相关性。
结果:使用WM方法根据髋臼成分的不同前倾和倾斜,在THACL后的射线照片上可视化髋臼成分的安全区。AA,RA,OA,OI,WM在男性和女性之间存在显着差异(p值<0.05)。随着解剖学倾斜或前倾的增加,WM前倾测量值也增加了。射线照相前倾测量与WM测量方法最匹配,其次是解剖和手术方法。
结论:可以使用3D虚拟程序,使用WM方法在CL射线照片上测量THA后髋臼成分的实际前倾,具有良好的重现性。
BACKGROUND: 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.
METHODS: 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.
RESULTS: 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 (p 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.
CONCLUSIONS: 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.