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Dynamic radiostereometric analysis for evaluation of hip joint pathomechanics

机译:动态放射线立体分析法评估髋关节病理力学

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BackgroundDynamic RSA (dRSA) enables non-invasive 3D motion-tracking of bones and may be used to evaluate in-vivo hip joint kinematics including hip pathomechanics such as femoroacetabular impingement (FAI) and the biomechanical effects of arthroscopic cheilectomy and -rim trimming (ACH).The study aim was to evaluate the kinematic changes in the hip joint after ACH. MethodsSeven non-FAI affected human cadaveric hips were CT-scanned and CT-bone models were created. dRSA recordings of the hip joints were acquired at five frames/s during passive flexion, adduction to stop, and internal rotation to stop (FADIR). ACH was performed and dRSA was repeated. dRSA images were analyzed using model-based RSA. Hip joint kinematics before and after ACH were compared pairwise. The volume of removed bone was quantified and compared to the postoperative range of motion (ROM). ResultsMean hip internal rotation increased from 19.1 to 21.9° ( p =?0.04, Δ2.8°, SD 2.7) after ACH surgery. Mean adduction of 3.9° before and 2.7° after ACH surgery was unchanged ( p =?0.48, Δ-1.2°; SD 4.3). Mean flexion angles during dRSA tests were 82.4° before and 80.8° after ACH surgery, which were similar ( p =?0.18, Δ-1.6°, SD?=?2.7). No correlation between volume of removed bone and ROM was observed. ConclusionsA small increase in internal rotation, but not in adduction, was observed after arthroscopic cheilectomy and -rim trimming in cadaver hips. The hip flexion angle of the FADIR test was reproducible. dRSA kinematic analysis is a new and clinically applicable method with good potential to evaluate hip joint kinematics and to test FAI pathomechanics and other surgical corrections of the hip.
机译:背景动态RSA(dRSA)可实现骨骼的非侵入性3D运动跟踪,并可用于评估体内髋关节运动学,包括股骨髋臼撞击(FAI)等髋关节病理力学以及关节镜下唇切开术和-rim修剪(ACH)的生物力学作用研究目的是评估ACH后髋关节的运动学变化。方法对7例未受FAI感染的人体尸体进行CT扫描,并创建CT骨模型。在被动屈曲,内收停止和内部旋转停止(FADIR)期间,以五帧/秒的速度获取髋关节的dRSA记录。进行ACH并重复dRSA。使用基于模型的RSA分析了dRSA图像。成对比较ACH前后的髋关节运动学。量化取出的骨头的体积,并将其与术后运动范围(ROM)进行比较。结果ACH手术后,平均髋关节内旋度从19.1°增加到21.9°(p =?0.04,Δ2.8°,SD 2.7)。 ACH手术前和手术后2.7°的平均内收均未改变(p =?0.48,Δ-1.2°; SD 4.3)。 dRSA测试期间,平均屈曲角度在ACH手术前为82.4°,在ACH手术后为80.8°,这是相似的(p =?0.18,Δ-1.6°,SD?=?2.7)。没有观察到取出的骨头的体积和ROM之间的相关性。结论在尸体臀部进行关节镜下的唇切除术和-rim修剪后,观察到内旋稍有增加,但没有内收。 FADIR测试的髋关节屈曲角度可重现。 dRSA运动学分析是一种新的且可在临床上应用的方法,具有很好的潜力来评估髋关节运动学,并测试FAI病理力学和其他髋关节手术矫正。

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