全髋关节置换术后髋关节发育不良的后髋关节撞击分析。

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-02-01 DOI:10.1016/j.clinbiomech.2024.106422

Hideki Shozen , Takeshi Shoji , Shinichi Ueki , Hiroki Kaneta , Yosuke Kozuma , Hiroyuki Morita , Nobuo Adachi

{"title":"全髋关节置换术后髋关节发育不良的后髋关节撞击分析。","authors":"Hideki Shozen , Takeshi Shoji , Shinichi Ueki , Hiroki Kaneta , Yosuke Kozuma , Hiroyuki Morita , Nobuo Adachi","doi":"10.1016/j.clinbiomech.2024.106422","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Total hip arthroplasty is the preferred treatment for advanced hip osteoarthritis, yet complications like hip dislocation (0.2 %–10 %) persist due to factors such as implant design, positioning, surgical technique, and patient-specific conditions. Impingement between prosthetic components or the acetabulum and proximal femur is a primary cause of instability.</div></div><div><h3>Methods</h3><div>A retrospective analysis of 120 patients (130 hips) undergoing total hip arthroplasty at XX Hospital (2011−2023) categorized patients by lateral center-edge angle: developmental dysplasia of the hip, borderline developmental dysplasia of the hip, and normal hip. ct imaging facilitated virtual 3D bone models for motion analysis, excluding cases with prior hip surgery or spinal fusion. Statistical analyses utilized the Mann–Whitney <em>U</em> test and one-way ANOVA.</div></div><div><h3>Findings</h3><div>The developmental dysplasia of the hip group showed the highest posterior impingement frequency, significantly affecting range of motion in flexion, adduction, and external rotation compared to borderline developmental dysplasia of the hip and normal hip groups. Variations in femoral neck anteversion, lesser trochanter version, and ischiofemoral space were notable. Posterior impingement commonly occurred between the lesser trochanter and ischial tuberosity.</div></div><div><h3>Interpretation</h3><div>Posterior bony impingement emerged as a predominant factor reducing range of motion and increasing dislocation risk, particularly in developmental dysplasia of the hip patients, challenging the conventional “safe zone” for implant positioning. Personalized surgical strategies tailored to individual bone morphology are crucial for enhancing total hip arthroplasty outcomes and minimizing complications, although limitations include the exclusion of soft tissue influences and focusing solely on range of motion until impingement occurs.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"122 ","pages":"Article 106422"},"PeriodicalIF":1.4000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Analysis of posterior hip joint impingement about developmental dysplasia of the hip after total hip arthroplasty\",\"authors\":\"Hideki Shozen , Takeshi Shoji , Shinichi Ueki , Hiroki Kaneta , Yosuke Kozuma , Hiroyuki Morita , Nobuo Adachi\",\"doi\":\"10.1016/j.clinbiomech.2024.106422\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Total hip arthroplasty is the preferred treatment for advanced hip osteoarthritis, yet complications like hip dislocation (0.2 %–10 %) persist due to factors such as implant design, positioning, surgical technique, and patient-specific conditions. Impingement between prosthetic components or the acetabulum and proximal femur is a primary cause of instability.</div></div><div><h3>Methods</h3><div>A retrospective analysis of 120 patients (130 hips) undergoing total hip arthroplasty at XX Hospital (2011−2023) categorized patients by lateral center-edge angle: developmental dysplasia of the hip, borderline developmental dysplasia of the hip, and normal hip. ct imaging facilitated virtual 3D bone models for motion analysis, excluding cases with prior hip surgery or spinal fusion. Statistical analyses utilized the Mann–Whitney <em>U</em> test and one-way ANOVA.</div></div><div><h3>Findings</h3><div>The developmental dysplasia of the hip group showed the highest posterior impingement frequency, significantly affecting range of motion in flexion, adduction, and external rotation compared to borderline developmental dysplasia of the hip and normal hip groups. Variations in femoral neck anteversion, lesser trochanter version, and ischiofemoral space were notable. Posterior impingement commonly occurred between the lesser trochanter and ischial tuberosity.</div></div><div><h3>Interpretation</h3><div>Posterior bony impingement emerged as a predominant factor reducing range of motion and increasing dislocation risk, particularly in developmental dysplasia of the hip patients, challenging the conventional “safe zone” for implant positioning. Personalized surgical strategies tailored to individual bone morphology are crucial for enhancing total hip arthroplasty outcomes and minimizing complications, although limitations include the exclusion of soft tissue influences and focusing solely on range of motion until impingement occurs.</div></div>\",\"PeriodicalId\":50992,\"journal\":{\"name\":\"Clinical Biomechanics\",\"volume\":\"122 \",\"pages\":\"Article 106422\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Biomechanics\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0268003324002547\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ENGINEERING, BIOMEDICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Biomechanics","FirstCategoryId":"5","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0268003324002547","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}

引用次数: 0

摘要

背景：全髋关节置换术是晚期髋关节骨性关节炎的首选治疗方法，但由于植入物设计、定位、手术技术和患者具体情况等因素，髋关节脱位等并发症（0.2% - 10%）持续存在。假体部件或髋臼与股骨近端之间的撞击是不稳定的主要原因。方法：回顾性分析2011-2023年XX医院行全髋关节置换术的120例患者（130髋），按外侧中心-边缘角度分为：髋关节发育不良、边缘性发育不良和正常髋关节。ct成像促进了虚拟三维骨模型的运动分析，排除了先前髋关节手术或脊柱融合的病例。统计分析采用Mann-Whitney U检验和单因素方差分析。结果：与髋关节发育不良和正常髋关节组相比，髋关节发育不良组的后撞击频率最高，显著影响屈曲、内收和外旋的活动范围。股骨颈前倾、小转子前倾和坐骨股骨间隙的变化是显著的。后撞击常发生在小转子和坐骨结节之间。解释：后路骨撞击是减少活动范围和增加脱位风险的主要因素，特别是在髋关节发育不良患者中，挑战了传统的植入物定位“安全区”。针对个体骨形态量身定制的个性化手术策略对于提高全髋关节置换术效果和减少并发症至关重要，尽管局限性包括排除软组织影响和仅关注运动范围直到发生撞击。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Analysis of posterior hip joint impingement about developmental dysplasia of the hip after total hip arthroplasty

Background

Total hip arthroplasty is the preferred treatment for advanced hip osteoarthritis, yet complications like hip dislocation (0.2 %–10 %) persist due to factors such as implant design, positioning, surgical technique, and patient-specific conditions. Impingement between prosthetic components or the acetabulum and proximal femur is a primary cause of instability.

Methods

A retrospective analysis of 120 patients (130 hips) undergoing total hip arthroplasty at XX Hospital (2011−2023) categorized patients by lateral center-edge angle: developmental dysplasia of the hip, borderline developmental dysplasia of the hip, and normal hip. ct imaging facilitated virtual 3D bone models for motion analysis, excluding cases with prior hip surgery or spinal fusion. Statistical analyses utilized the Mann–Whitney U test and one-way ANOVA.

Findings

The developmental dysplasia of the hip group showed the highest posterior impingement frequency, significantly affecting range of motion in flexion, adduction, and external rotation compared to borderline developmental dysplasia of the hip and normal hip groups. Variations in femoral neck anteversion, lesser trochanter version, and ischiofemoral space were notable. Posterior impingement commonly occurred between the lesser trochanter and ischial tuberosity.

Interpretation

Posterior bony impingement emerged as a predominant factor reducing range of motion and increasing dislocation risk, particularly in developmental dysplasia of the hip patients, challenging the conventional “safe zone” for implant positioning. Personalized surgical strategies tailored to individual bone morphology are crucial for enhancing total hip arthroplasty outcomes and minimizing complications, although limitations include the exclusion of soft tissue influences and focusing solely on range of motion until impingement occurs.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.