Vera M Stetzelberger, Jannine T Segessenmann, Cem Cek, Vlad Popa, Joseph M Schwab, Corinne A Zurmühle, Alexander F Heimann, Moritz Tannast
{"title":"验证新生物力学概念的计算机模型--髋窝-髋窝错位--髋关节韧带窝-髋窝复合体病变的答案?","authors":"Vera M Stetzelberger, Jannine T Segessenmann, Cem Cek, Vlad Popa, Joseph M Schwab, Corinne A Zurmühle, Alexander F Heimann, Moritz Tannast","doi":"10.1007/s00402-024-05508-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Hip-preserving surgery in young patients frequently reveals lesions of the ligamentum teres (LT). Histological and clinical evidence supports that those lesions could be source of intraarticular hip pain. It has been hypothesized that LT degeneration could be linked to the abnormal positioning of the fovea outside the lunate surface during various daily motions. We introduce the \"fossa-foveolar mismatch\" (FFM) by determining the trajectory of the fovea in the fossa during hip motions, enabling a comparison across diverse hip-pathomorphologies.</p><p><strong>Aims: </strong>to determine (1) intraobserver reliability and (2) interobserver reproducibility of our computer-assisted 3-dimensional (3D) model of the FFM.</p><p><strong>Materials and methods: </strong>All patients with joint preserving surgery for femoroacetabular impingement syndrome (FAIS) or developmental dysplasia of the hip (DDH) at our institution (11. 2015-08.2019)were initially eligible. We employed a simple random sampling technique to select 15 patients for analysis. Three-dimensional surface models based on preoperative computed tomography (CT) scans were built, the fossa virtually excised, the fovea capitis marked. Models were subjected to physiological range of motion with validated 3D collision detection software. Using a standardized medial view on the resected fossa and the transparent lunate surface, the FFM-index was calculated for 17 motions. It was obtained by dividing the surface occupied by the fovea outside of the fossa by the total foveolar tracking surface. Three observers independently performed all analyses twice. (1) Intraobserver reliability and (2) interobserver reproducibility were calculated using intraclass correlation coefficients (ICCs).</p><p><strong>Results: </strong>(1) We obtained excellent intraobserver ICCs for the FFM-index averaging 0.92 with 95% CI 0.77-0.9 among the three raters for all motions. (2) Interobserver reproducibility between raters was good to excellent, ranging from 0.76 to 0.98.</p><p><strong>Conclusions: </strong>The FFM-index showed excellent intraobserver reliability and interobserver reproducibility for all motions. This innovative approach deepens our understanding of biomechanical implications, providing valuable insights for identifying patient populations at risk.</p>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":" ","pages":"4207-4215"},"PeriodicalIF":2.0000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564260/pdf/","citationCount":"0","resultStr":"{\"title\":\"Validation of a computerized model for a new biomechanical concept- the fossa-foveolar mismatch- the answer to lesions of the ligamentous fossa-foveolar complex in the hip?\",\"authors\":\"Vera M Stetzelberger, Jannine T Segessenmann, Cem Cek, Vlad Popa, Joseph M Schwab, Corinne A Zurmühle, Alexander F Heimann, Moritz Tannast\",\"doi\":\"10.1007/s00402-024-05508-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Hip-preserving surgery in young patients frequently reveals lesions of the ligamentum teres (LT). Histological and clinical evidence supports that those lesions could be source of intraarticular hip pain. It has been hypothesized that LT degeneration could be linked to the abnormal positioning of the fovea outside the lunate surface during various daily motions. We introduce the \\\"fossa-foveolar mismatch\\\" (FFM) by determining the trajectory of the fovea in the fossa during hip motions, enabling a comparison across diverse hip-pathomorphologies.</p><p><strong>Aims: </strong>to determine (1) intraobserver reliability and (2) interobserver reproducibility of our computer-assisted 3-dimensional (3D) model of the FFM.</p><p><strong>Materials and methods: </strong>All patients with joint preserving surgery for femoroacetabular impingement syndrome (FAIS) or developmental dysplasia of the hip (DDH) at our institution (11. 2015-08.2019)were initially eligible. We employed a simple random sampling technique to select 15 patients for analysis. Three-dimensional surface models based on preoperative computed tomography (CT) scans were built, the fossa virtually excised, the fovea capitis marked. Models were subjected to physiological range of motion with validated 3D collision detection software. Using a standardized medial view on the resected fossa and the transparent lunate surface, the FFM-index was calculated for 17 motions. It was obtained by dividing the surface occupied by the fovea outside of the fossa by the total foveolar tracking surface. Three observers independently performed all analyses twice. (1) Intraobserver reliability and (2) interobserver reproducibility were calculated using intraclass correlation coefficients (ICCs).</p><p><strong>Results: </strong>(1) We obtained excellent intraobserver ICCs for the FFM-index averaging 0.92 with 95% CI 0.77-0.9 among the three raters for all motions. (2) Interobserver reproducibility between raters was good to excellent, ranging from 0.76 to 0.98.</p><p><strong>Conclusions: </strong>The FFM-index showed excellent intraobserver reliability and interobserver reproducibility for all motions. This innovative approach deepens our understanding of biomechanical implications, providing valuable insights for identifying patient populations at risk.</p>\",\"PeriodicalId\":8326,\"journal\":{\"name\":\"Archives of Orthopaedic and Trauma Surgery\",\"volume\":\" \",\"pages\":\"4207-4215\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564260/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of Orthopaedic and Trauma Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00402-024-05508-x\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/9/23 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Orthopaedic and Trauma Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00402-024-05508-x","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/23 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Validation of a computerized model for a new biomechanical concept- the fossa-foveolar mismatch- the answer to lesions of the ligamentous fossa-foveolar complex in the hip?
Background: Hip-preserving surgery in young patients frequently reveals lesions of the ligamentum teres (LT). Histological and clinical evidence supports that those lesions could be source of intraarticular hip pain. It has been hypothesized that LT degeneration could be linked to the abnormal positioning of the fovea outside the lunate surface during various daily motions. We introduce the "fossa-foveolar mismatch" (FFM) by determining the trajectory of the fovea in the fossa during hip motions, enabling a comparison across diverse hip-pathomorphologies.
Aims: to determine (1) intraobserver reliability and (2) interobserver reproducibility of our computer-assisted 3-dimensional (3D) model of the FFM.
Materials and methods: All patients with joint preserving surgery for femoroacetabular impingement syndrome (FAIS) or developmental dysplasia of the hip (DDH) at our institution (11. 2015-08.2019)were initially eligible. We employed a simple random sampling technique to select 15 patients for analysis. Three-dimensional surface models based on preoperative computed tomography (CT) scans were built, the fossa virtually excised, the fovea capitis marked. Models were subjected to physiological range of motion with validated 3D collision detection software. Using a standardized medial view on the resected fossa and the transparent lunate surface, the FFM-index was calculated for 17 motions. It was obtained by dividing the surface occupied by the fovea outside of the fossa by the total foveolar tracking surface. Three observers independently performed all analyses twice. (1) Intraobserver reliability and (2) interobserver reproducibility were calculated using intraclass correlation coefficients (ICCs).
Results: (1) We obtained excellent intraobserver ICCs for the FFM-index averaging 0.92 with 95% CI 0.77-0.9 among the three raters for all motions. (2) Interobserver reproducibility between raters was good to excellent, ranging from 0.76 to 0.98.
Conclusions: The FFM-index showed excellent intraobserver reliability and interobserver reproducibility for all motions. This innovative approach deepens our understanding of biomechanical implications, providing valuable insights for identifying patient populations at risk.
期刊介绍:
"Archives of Orthopaedic and Trauma Surgery" is a rich source of instruction and information for physicians in clinical practice and research in the extensive field of orthopaedics and traumatology. The journal publishes papers that deal with diseases and injuries of the musculoskeletal system from all fields and aspects of medicine. The journal is particularly interested in papers that satisfy the information needs of orthopaedic clinicians and practitioners. The journal places special emphasis on clinical relevance.
"Archives of Orthopaedic and Trauma Surgery" is the official journal of the German Speaking Arthroscopy Association (AGA).