基于3D重建技术探讨发育性髋关节发育不良患者膝关节形态差异  

Exploring the Differences in Knee Joint Morphology in Patients with Developmental Hip Dysplasia Based on 3D Reconstruction Technology

作　　者：林天烨 江禹来 何晓铭 何敏聪 李子祺 陈镇秋[4] 张庆文 何伟 魏秋实 Lin Tianye;Jiang Yulai;He Xiaoming;He Mincong;Li Ziqi;Chen Zhenqiu;Zhang Qingwen;He Wei;Wei Qiushi(Digital Orthopaedic Research Office of Guangdong Traditional Chinese Medicine Orthopaedic Research Institute,Guangzhou 510405,China;Joint Center of the Third Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,China;The Third Clinical School of Guangzhou University of Chinese Medicine,Guangzhou 510405,China;Department of Arthrology,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,China)

机构地区：[1]广东省中医骨伤研究院数字骨伤研究室,广东广州510405 [2]广州中医药大学第三附属医院关节中心,广东广州510405 [3]广州中医药大学第三临床医学院,广东广州510405 [4]广州中医药大学第一附属医院关节科,广东广州510405

出　　处：《实用骨科杂志》2024年第1期18-23,共6页Journal of Practical Orthopaedics

基　　金：广东省中医药管理局项目(20223012);广州中医药大学第三附属医院科研创新基金课题(Sy2022002)。

摘　　要：目的本研究通过3D重建技术探讨发育性髋关节发育不良(developmental dysplasia of the hip,DDH)患者膝关节参数的差异,为DDH患者行髋膝手术提供数据参考。方法2019年1月至2022年12月前瞻性招募127例DDH患者,其中单侧DDH组98例,双侧DDH组29例(58膝),对照组(健康体检者)110例。单侧DDH组男28例,女70例;平均年龄(35.40±11.62)岁。双侧DDH组男7例,女22例;平均年龄(36.17±12.58)岁。对照组男32例,女78例;平均年龄(35.82±11.49)岁。收集三组患者CT数据进行三维重建,基于三维重建模型下测量膝关节相关参数,股骨内侧髁宽度(width of medial femoral condyle,WMFC)、股骨外侧髁宽度(width of lateral femoral condyle,WLFC)股骨内侧髁高度(height of medial femoral condyle,HMFC)、股骨外侧髁高度(height of lateral femoral condyle,HLFC)、胫骨内侧平台宽度(width of medial tibial platform,WMTP)、胫骨外侧平台宽度(width of lateral tibial platform,WLTP)、股骨前关节边缘距离(femoral anterior joint edge distance,FAJED)、股骨后关节边缘距离(femoral posterior joint edge distance,FPJED)、胫骨前关节边缘距离(tibial anterior joint edge distance,TAJED)、胫骨后关节边缘距离(tibial posterior joint edge distance,TPJED)、胫股角(femorotibial angle,FTA)、股骨远端外侧角(lateral distal femoral angle,LDFA)、胫骨近端内侧角(medial proximal tibial angle,MPTA)、胫骨近端后侧角(posterior proximal tibial angle,PPTA)、股骨远端后侧角(posterior distal femoral angle,PDFA)。对比三组膝关节正视位图、侧视位图及角度相关参数。结果对照组WLFC、WLTP、LDFA显著大于单侧DDH组、双侧DDH组(P<0.05),单侧DDH组WLFC、WLTP、LDFA显著大于双侧DDH组(P<0.05)。对照组HMFC显著小于单侧DDH组、双侧DDH组(P<0.05),双侧DDH组HMFC大于单侧DDH组(P<0.05)。对照组WMTP显著小于单侧DDH组(P<0.05),单侧DDH组WMTP显著大于双侧DDH组(P<0.05),双侧DDH组WMTP与对照组比较差异无统计学意�Objective To explore the differences in knee joint parameters among developmental dysplasia of the hip(DDH)patients through 3D reconstruction technology,providing data reference for hip and knee surgery in DDH patients.Methods From January 2019 to December 2022,127 DDH patients were prospectively recruited,including 98 cases in the unilateral DDH group,29 cases(58 knees)in the bilateral DDH group,and 110 cases in the control group(healthy individuals).28 males and 70 females were included in the unilateral DDH group.The average age was(35.40±11.62)years old.There were 7 males and 22 females in the bilateral DDH group.The average age was(36.17±12.58)years old.32 males and 78 females were included in the control group.The average age is(35.82±11.49)years old.We collected CT data from three groups of patients for 3D reconstruction,and measure knee joint related parameters based on the 3D reconstruction model,including width of medial femoral condyle(WMFC),width of lateral femoral condyle(WLFC),height of medial femoral condyle(HMFC),height of lateral femoral condyle(HLFC),and width of medial tibial platform(WMTP)Width of lateral tibial platform(WLTP),femoral anterior joint edge distance(FAJED),femoral posterior joint edge distance(FPJED),tibial anterior joint edge distance(TAJED),and tibial posterior joint edge distance(TPJED),femorofemoral angle(FTA),lateral distal femoral angle(LDFA),medial proximal tibial angle(MPTA),posterior posterior tibial angle(PPTA),and posterior posterior femoral angle(PDFA).The knee joint orthographies and angle related parameters were compared.Results The WLFC,WLTP,and LDFA in the control group were significantly higher than those in the unilateral DDH group and bilateral DDH group(P<0.05),while the WLFC,WLTP,and LDFA in the unilateral DDH group were significantly higher than those in the bilateral DDH group(P<0.05).The HMFC of the control group was significantly smaller than that of the unilateral DDH group and bilateral DDH group(P<0.05),and the HMFC of the bilateral DDH group was gr

关 键 词：发育性髋关节发育不良 膝关节 外翻 三维 影像 

分 类 号：R681.6[医药卫生—骨科学]