Visualization of a cam-type femoroacetabular impingement while squatting using image-matching techniques: a case report
Visualization of a cam-type femoroacetabular impingement while squatting using image-matching techniques: a case report
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DOI：
10.1007/s00256-017-2677-7
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发表时间：
2017-09-01
影响因子：
2.1
通讯作者：
Nakashima, Yasuharu
中科院分区：
文献类型：
--
作者：
Yoshimoto, Kensei;Hamai, Satoshi;Nakashima, Yasuharu
髋臼撞击(FAI)患者在负重状态下髋关节三维运动学的活体评估尚未见报道。我们评估了一名34岁男性，在蹲着时，使用图像匹配技术和测量颈缘距离的凸轮型FAI的髋关节运动学。术后α角由51.0度改善至35.5度，头颈偏移比由0.04度改善至0.23度。下蹲时髋关节疼痛消失，术后1年Harris髋关节评分从79分提高到92分。术后髋关节运动学值(骨盆后倾角3.8°，股骨最大屈曲角度96.8°，股骨屈曲角度101.2°)与术前相近(骨盆后倾角2.9°，股骨屈曲角度102.7°，髋关节最大屈曲角度98.8A)。同时，骨软骨成形术使髋关节最大屈曲时的最小颈缘距离由2.0 mm提高到10.4 mm。活体三维显示股骨头颈交界处与髋臼之间的间隙可以帮助外科医生充分识别撞击的位置，并确定手术后的充分切除。
The in vivo assessment of the three-dimensional (3D) kinematics of the hip in patients with femoroacetabular impingement (FAI) under weight-bearing conditions has not been previously reported. We evaluated the pre- and postoperative hip kinematics of a 34-year-old man, with a cam-type FAI while squatting, using image-matching techniques with measurement of the rim-neck distance. Post-osteochondroplasty, the alpha-angle improved from 51.0 degrees to 35.5 degrees and the head-neck offset ratio from 0.04 to 0.23. Coxalgia during squatting disappeared, and the Harris Hip Score improved from 79 to 92 at 1 year post-surgery. Postoperative hip kinematic values (3.8 degrees of posterior pelvic tilt and 101.2 degrees of femoral flexion at 96.8 degrees of maximum hip flexion) were similar to the preoperative values (2.9 degrees of posterior pelvic tilt and 102.7 degrees of femoral flexion at 98.8A degrees of maximum hip flexion). Meanwhile, osteochondroplasty improved the minimum rim-neck distance at maximum hip flexion from 2.0 to 10.4 mm. In vivo 3D visualization of the clearance between the femoral head-neck junction and the acetabulum could assist surgeons in adequately identifying the location of impingement and confirming sufficient resection post-operatively.