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Dynamic hip kinematics before and after periacetabular osteotomy in patients with dysplasia.

发育不良患者髋臼周围截骨前后的髋关节动态运动学。

  • 影响因子:1.36
  • DOI:10.1016/j.jos.2019.03.019
  • 作者列表:"Yoshimoto K","Hamai S","Higaki H","Gondoh H","Shiomoto K","Ikebe S","Hara D","Komiyama K","Nakashima Y
  • 发表时间:2020-03-01
Abstract

BACKGROUND:We prospectively analyzed the hip kinematics in patients with developmental dysplasia of the hip (DDH) before and after periacetabular osteotomy (PAO) and in healthy subjects while squatting to determine the influence of coverage of the femoral head on hip kinematics. METHODS:14 hips in 14 patients with DDH and 10 hips in 10 volunteers were included. Continuous radiographs while squatting and computed tomography images were obtained to assess the in vivo kinematics of the hip and the rim-neck distance using density-based 3D-to-2D model-to-image registration techniques. RESULTS:The maximum hip flexion angles were 100.4° and 94.9° before and after PAO (p = 0.0863), respectively. The maximum hip flexion angles after PAO did not significantly differ from those of normal hips (102.2°; p = 0.2552). The hip abduction angles at maximum hip flexion were 31.7° and 26.2° before and after PAO (p = 0.1256), respectively. The rim-neck distance decreased from averaged 12.2 mm-8.9 mm (p = 0.0044) after PAO. The lateral center edge angle (LCEA) and anterior center edge angle (ACEA) significantly improved 14.7°-42.4° and 50.4°-54.0° after PAO (p < 0.0001, p = 0.0347), respectively; in particular, the ACEA after PAO did not significantly differ from that in the normal hips (p = 0.1917). The ACEA was not correlated with hip flexion, or the rim-neck distance (p = 0.9601, 0.8764). The LCEA was also not correlated with hip abduction (p = 0.1683). CONCLUSION:Patients after PAO showed no significant difference in maximum hip flexion while squatting compared to before PAO and normal hips. Horizontalized weight-bearing acetabulum with normalized ACEA could be adequate correction of the acetabular fragment to restore hip RoM without coxalgia that induce the inability to perform squats after PAO.

摘要

背景: 我们前瞻性地分析了发育性髋关节发育不良 (DDH) 患者髋臼周围截骨术 (PAO) 前后和健康受试者下蹲时的髋关节运动学,以确定股骨头覆盖对髋关节运动学的影响。 方法: 纳入14例DDH患者14髋,10例志愿者10髋。获得下蹲时的连续射线照片和计算机断层扫描图像,以使用基于密度的3d--2d模型-图像配准技术评估髋部的体内运动学和边缘-颈部距离。 结果: PAO前后髋关节最大屈曲角度分别为100.4 ° 和94.9 ° (p = 0.0863)。PAO后的最大髋关节屈曲角度与正常髋关节无显著差异 (102.2 °; p = 0.2552)。PAO前后髋关节最大屈曲时的髋关节外展角分别为31.7 ° 和26.2 ° (p = 0.1256)。在PAO后,边缘-颈部距离从平均12.2毫米-8.9毫米 (p = 0.0044) 减小。外侧中心边缘角 (LCEA) 和前中心边缘角 (ACEA) 在PAO后分别显著改善14.7 °-42.4 ° 和50.4 °-54.0 ° (p <0.0001,p = 0.0347); 特别是,PAO后的ACEA与正常髋关节无显著差异 (p = 0.1917)。ACEA与髋关节屈曲或边缘-颈部距离无关 (p = 0.9601,0.8764)。LCEA也与髋关节外展无关 (p = 0.1683)。 结论: PAO术后患者下蹲时髋关节最大屈曲度与PAO前及正常髋关节相比无明显差异。具有标准化ACEA的水平负重髋臼可以充分矫正髋臼碎片以恢复髋关节RoM,而不会导致不能在PAO后进行下蹲。

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影响因子:2.98
发表时间:2020-01-01
DOI:10.1136/neurintsurg-2019-014962
作者列表:["Guo W","Liu H","Tan Z","Zhang X","Gao J","Zhang L","Guo H","Bai H","Cui W","Liu X","Wu X","Luo J","Qu Y"]

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影响因子:0.96
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