Quantitative comparison of cortical bone thickness using correspondence-based shape modeling in patients with cam femoroacetabular impingement.
Quantitative comparison of cortical bone thickness using correspondence-based shape modeling in patients with cam femoroacetabular impingement.
复制标题
DOI：
10.1002/jor.23468
复制
发表时间：
2017-08
期刊：
影响因子：
--
通讯作者：
Anderson AE
中科院分区：
文献类型：
--
作者：
Atkins PR;Elhabian SY;Agrawal P;Harris MD;Whitaker RT;Weiss JA;Peters CL;Anderson AE
凸轮型股髋臼撞击（FAI）患者股骨近端形状异常。撞击可引起股骨近端骨重塑，导致皮质骨厚度增加。我们使用基于对应的形状建模来量化和比较cam患者和对照组之间的皮质厚度，以确定cam病变和股骨近端位置。对45例对照组和28例cam型FAI患者进行计算机断层扫描图像分割。将这些分割输入到基于对应的形状模型中，以识别凸轮病变的区域。在混合性别组和性别特异性组之间比较cam病变区域和股骨近端皮质中值厚度数据。FAI患者的中位厚度（四分位间距）明显大于对照组（分别为1.47[0.64]比1.13 [0.22]mm, p<0.001）和股骨近端（分别为1.28[0.30]比0.97 [0.22]mm, p<0.001）。在FAI患者中，凸轮病变区域的最大厚度更多的是前部，较少的是外侧（p<0.001）。男性FAI患者与男性对照组相比，cam病变厚度增加（分别为1.47[0.72]比1.10 [0.19]mm, p<0.001），股骨近端厚度增加（分别为1.25[0.29]比0.94 [0.17]mm, p<0.001）。男性和女性之间的厚度差异不显著。临床意义：对非病理性尸体的研究为FAI患者的安全手术切除深度提供了指导。然而，我们的研究结果表明，撞击会导致cam患者的皮质增厚，这可能会加强股骨近端。因此，这些先前制定的指导方针可能过于保守。
The proximal femur is abnormally shaped in patients with cam-type femoroacetabular impingement (FAI). Impingement may elicit bone remodeling at the proximal femur, causing increases in cortical bone thickness. We used correspondence-based shape modeling to quantify and compare cortical thickness between cam patients and controls for the location of the cam lesion and the proximal femur. Computed tomography images were segmented for 45 controls and 28 cam-type FAI patients. The segmentations were input to a correspondence-based shape model to identify the region of the cam lesion. Median cortical thickness data over the region of the cam lesion and the proximal femur were compared between mixed-gender and gender-specific groups. Median [interquartile range] thickness was significantly greater in FAI patients than controls in the cam lesion (1.47 [0.64] vs. 1.13 [0.22] mm, respectively; p<0.001) and proximal femur (1.28 [0.30] vs. 0.97 [0.22] mm, respectively; p<0.001). Maximum thickness in the region of the cam lesion was more anterior and less lateral (p<0.001) in FAI patients. Male FAI patients had increased thickness compared to male controls in the cam lesion (1.47 [0.72] vs. 1.10 [0.19] mm, respectively; p<0.001) and proximal femur (1.25 [0.29] vs. 0.94 [0.17] mm, respectively; p<0.001). Thickness was not significantly different between male and female controls. Clinical significance: Studies of non-pathologic cadavers have provided guidelines regarding safe surgical resection depth for FAI patients. However, our results suggest impingement induces cortical thickening in cam patients, which may strengthen the proximal femur. Thus, these previously established guidelines may be too conservative.