三维轴定向有助于同时对所有三种解剖面的对齐校正,在开门高骨切除术中
Quinten W T Veerman1,2, Romy M Ten Heggeler1,2, Gabriëlle J M Tuijthof2
1OCON Centre for Orthopaedic Surgery and Sports Medicine, Hengelo, the Netherlands.
Arthroscopy, sports medicine, and rehabilitation
|February 15, 2024
概括
在高骨切除术中研究3D轴定向揭示了轴旋转会影响冠状和斜面平面,而倾斜主要影响轴轴对齐,以便更好地进行手术规划.
科学领域:
- 整形外科手术 整形外科手术
- 生物机械工程 生物机械工程
- 计算解剖学的计算解剖学
背景情况:
- 高骨切除术 (HTO) 是治疗膝关节骨关节炎和位不良的常见手术.
- 在所有三个解剖平面上准确地纠正骨对齐对于成功的结果至关重要.
- 了解手术技术变化的影响,例如轴 (HA) 方向,对于优化HTO结果至关重要.
研究的目的:
- 为了研究三维 (3D) 轴 (HA) 定向在高骨切除 (HTO) 过程中,在所有三个解剖平面上对骨对齐参数的同时影响.
- 量化HA旋转和倾斜的变化如何影响冠状,斜和轴轴对齐的变化.
- 为改善HTO手术程序的外科规划和执行提供见解.
主要方法:
- 基于计算机断层扫描 (CT) 的骨/骨3D模型的开发,以建立一个3D骨坐标系统.
- 模拟一个开口形HTO,在HA周围旋转10°.
- 系统地改变HA方向,包括轴平面旋转 (0°-90°) 和倾斜 (-20°至+20°),以评估对齐参数的变化.
主要成果:
- 骨轴平面中的HA旋转显著影响了冠状和斜面平面对齐 (0°-9.7°变化),两者之间的关系是反向的.
- HA旋转对轴平面对齐的影响很小 (≤0.9°变化).
- 与骨轴平面相对的HA倾斜主要影响了轴线对齐 (高达6.9°的变化),对冠状和斜面平面 (≤0.6°的变化) 产生轻微影响.
结论:
- 骨轴平面中HA的旋转是HTO中 sagittal和coronal平面对齐变化的主要驱动因素.
- 与骨轴平面相对的HA倾斜主要影响轴平面对齐.
- 将3D HA定位整合到手术规划中可以最大限度地减少意外的多平面错误,并促进HTO中精确的多平面纠正.
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