3D手术模拟测量Crowe Ⅳ型发育性髋关节发育不良的真实髋臼形态  

True acetabulum morphology of Crowe type IV developmental dysplasia of the hip based on three-dimensional surgical simulation

作　　者：康朋 张方新 买合木提·亚库甫 魏伟涛 伊力哈木·托合提[1] 艾尔肯·阿木冬[1] Kang Peng;Zhang Fangxin;Maihemuti·Yakufu;Wei Weitao;Yilihamu·Toheti;Aierken·Amudong(Department of Sports Injury,Sixth Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]新疆医科大学第六附属医院运动损伤科,新疆维吾尔自治区乌鲁木齐市830000

出　　处：《中国组织工程研究》2020年第36期5749-5754,共6页Chinese Journal of Tissue Engineering Research

基　　金：新疆医科大学研究生创新创业启动基金项目(CXCY2018031),项目负责人:康朋;新疆维吾尔自治区研究生科研创新项目(XJ2019G207),项目负责人:康朋。

摘　　要：背景:Crowe Ⅳ型发育性髋关节发育不良患者的髋关节解剖畸形程度比较大,3D图像在反映真实髋臼(真臼)形态特征和评估髋臼参数方面有独特优势,因此有必要对Crowe Ⅳ型发育性髋关节发育不良的真臼进行定性定量的3D形态分析。目的:基于3D手术模拟技术探讨Crowe Ⅳ型发育性髋关节发育不良患者的真臼形态特征。方法:将Crowe Ⅳ型发育性髋关节发育不良患者20例(22髋)和正常对照组22例(22髋)纳入研究。将CT原始数据导入Mimics软件中,建立髋臼三维数字化可视模型,利用3D手术模拟技术实现真臼重建,确定真臼旋转中心,描述髋臼形态的特点。在3-matic软件中测量髋臼前倾角、髋臼外展角,对Crowe Ⅳ型发育性髋关节发育不良的真臼定性定量地进行3D形态分析。结果与结论:①Crowe Ⅳ型发育性髋关节发育不良组的真臼形态呈上窄下宽的三角形,模拟臼杯放置的理想中心大致位于后部骨壁的上方;②Crowe Ⅳ型发育性髋关节发育不良组患者的髋臼前倾角(35.07±3.09)°显著大于对照组髋臼前倾角(15.89±3.14)°,差异有显著性意义(P <0.05);③Crowe Ⅳ型发育性髋关节发育不良组患者的髋臼外展角(46.87±2.73)°显著大于对照组髋臼外展角(43.88±2.60)°,差异有显著性意义(P <0.05);④通过使用3D手术模拟技术可使发育性髋关节发育不良患者真臼的形态特征得到全面评估,发育性髋关节发育不良患者在进行全髋关节置换前必须谨慎地进行个体化术前计划。BACKGROUND:Patients with Crowe type IV developmental dysplasia of the hip have a greater degree of hip anatomy deformity.Three-dimensional images have unique advantages in reflecting the morphological characteristics of the true acetabulum and evaluating acetabular parameters.Therefore,it is necessary to qualitatively and quantitatively evaluate three-dimensional morphological analysis of the true acetabularity of Crowe type IV developmental dysplasia of the hip.OBJECTIVE:To explore the morphological characteristics of true acetabulum in patients with Crowe type IV developmental dysplasia of the hip based on three-dimensional surgical simulation technology.METHODS:Twenty patients(22 hips)of Crowe type IV developmental dysplasia of the hip and 22 normal controls(22 hips)were included in the study.The original CT data were imported into Mimics software,and a three-dimensional digital visual model of the acetabulum was established.The three-dimensional surgical simulation technology was used to reconstruct the true acetabulum,determine the true acetabular rotation center,and describe the characteristics of the acetabular morphology.Acetabular anteversion angle and acetabular abduction angle were measured in 3-matic software.Qualitative and quantitative three-dimensional morphological analysis was conducted in the true acetabulum of Crowe type IV developmental dysplasia of the hip.RESULTS AND CONCLUSION:(1)The true morphology of the Crowe type IV dysplasia group was a triangle with a narrow upper and lower width.The ideal center for simulating the cup placement was approximately above the posterior bone wall.(2)Acetabular anteversion angle in the Crowe type IV dysplasia group(35.07±3.09)°was significantly increased compared with the control group(15.89±3.14)°,and the difference was statistically significant(P<0.05).(3)Acetabular abduction angle in the Crowe type IV dysplasia group(46.87±2.73)°was larger than in the control group(43.88±2.60)°,and the difference was statistically significant(P<0.05).(4)The morp

关 键 词：髋 关节 发育不良 三维重建 CroweⅣ型 髋臼 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]