Bernese髋臼截骨术术前规划中骨盆建模对结果的影响

The Effect of Pelvic Modeling on Outcome in Preoperative Planning for Bernese Acetabular Osteotomy

目的探究在Bernese髋臼截骨术的术前规划中不同建模完整程度对髋臼应力分布和截骨最佳角度结果的影响。方法对1位髋关节发育不良患者按照建模完整程度不同建立两个模型,模型1包括患侧髋骨和股骨,模型2包括完整骨盆及患侧股骨。对比分析两个模型单腿站立情况下髋臼软骨接触压力、面积和分布情况,并模拟截骨,分析两种建模方式对术前规划结果的影响。结果术前模型2相比模型1接触压力大、接触面积小,并且分布更靠近髋臼月状面上边缘。比较11个术后方案,模型1的接触压力变化幅值和最佳截骨角度均小于模型2。结论建模完整程度只有患侧髋骨和股骨的术前分析结果会低估应力集中程度和误判应力集中点的位置,并且其最佳截骨旋转角度结果较小。研究结果为截骨术前规划建模提供一定理论依据。

Objective To explore the influence of different model scopes on acetabular stress distribution and optimal osteotomy result in preoperative planning of Bernese acetabular osteotomy.Methods Two patients with hip dysplasia were established according to different model ranges.Model 1 included the affected hip and femur,and Model 2 included the complete pelvis and affected femur.Compare and analyze the acetabular cartilage contact pressure,area and distribution of the two models under single-leg standing conditions,and simulate osteotomy.Results Compared with Model 1 before surgery,Model 2 had higher contact pressure,smaller contact area and closer distribution to the meniscus edge of acetabulum.Compared with 11 postoperative plans,the variation amplitude of contact pressure and the optimal osteotomy angle for Model 1 were all smaller than those of Model 2.Conclusions The preoperative analysis result of the model with affected hip bone and femur would underestimate the degree of stress concentration and misjudge the location of stress concentration,and the obtained optimal osteotomy rotation angle would be relatively small.The research findings provide certain theoretical basis for preoperative planning and modeling of osteotomy.