Abstract

Acetabular reconstruction remains to be one of the crucial aspects of total hip replacament in developmental dysplasia of the hip (DDH) that provides endoprosthesis’ long-term stability and general success of the operation. Among the parameters that influence surgical technique of acetabular reconstruction, medial wall bone stock of the endoprosthesis’ bed zone should be taken into consideration. Purpose of the work to assess medial wall bone stock in the site of acetabular component’s bony bed in normal and dysplastic deformed hips and to define correlation with indices of sphericity and sectoral deficiency of the acetabulum based on MSCT-morphomerty. Materials and methods. A complex comparative MSCT-mophometric investigation of 32 normal hips and 65 hips with DDH (Crowe I – 26 hips (40.0 %), Crowe II – 23 hips (35.4 %), Crowe III – 16 hips (24.6 %)) was performed. There were assessed width of the medial wall bone stock in the projection of the crucial ligament’s and acetabular component’s bony beds according to the proposed method; their correlation with indices of femoral head’s cranial migration and acetabular horizontal sphericity angle. Results. It has been revealed that measurements in he site of the crucial ligament’s bony bed based on pelvic images obtained by a conventional biplanar X-ray remains to be biased and doesn’t correspond to true width of medial acetabular wall bone stock. Absolute width of the medial acetabular wall in sites of the crucial ligament’s / acetabular component’s bony beds carried out through the special MSCT-recontruction methodic was defined as: 4.3 mm [3.3; 4.8]/7,2 mm [6.2; 7.8] for normal hips, 9.95 mm [7.5; 11.6]/11.85 mm [9.8; 13.5] for Crowe I hips,15 mm [11.7; 17.3]/15,7 mm [13,5; 17,3] for Crowe II hips and 15.45 mm [13.7; 19.8]/16.05 mm [12.8; 20.2] for Crowe III hips, respectively. Correlations between medial acetabular wall bone stock in site of acetabular component’s bony bed and indices of femoral head’s cranial migration and acetabular horizontal sphericity angle were defined as: r = 0.36 (P = 0.006); r = 0.36 (P = 0.007), respectively. Conclusions. Weak correlation of medial acetabular wall bone stock with indices of acetabular sphericity and sectoral deficiency requires the necessity of independent evaluation of this index during preoperative planning. Due to the impossibility of the index assessment based on the conventional pelvic X-ray, application of elaborated MSCT-morphometric methodic seems to be clinically valuable and should be applied during preoperative examination of patients with DDH.

Highlights

  • Цель работы – оценка состояния костного массива медиальной стенки вертлужной впадины (ВВ) в проекции имплантационного ложа ацетабулярного компонента (АК) в норме и при диспластическом коксартрозе (ДК), определение его взаимосвязи с показателями сферичности и секторального дефицита ВВ на основании МСКТ-морфометрии

  • Purpose of the work to assess medial wall bone stock in the site of acetabular component’s bony bed in normal and dysplastic deformed hips and to define correlation with indices of sphericity and sectoral deficiency of the acetabulum based on MSCT-morphomerty

  • It has been revealed that measurements in he site of the crucial ligament’s bony bed based on pelvic images obtained by a conventional biplanar X-ray remains to be biased and doesn’t correspond to true width of medial acetabular wall bone stock

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Summary

Original research

Цель работы – оценка состояния костного массива медиальной стенки ВВ в проекции имплантационного ложа АК в норме и при ДК, определение его взаимосвязи с показателями сферичности и секторального дефицита ВВ на основании МСКТ-морфометрии. Оценивали толщину медиальной стенки ВВ в проекции ложа круглой связки и зоны имплантации АК по предложенной методике, корреляцию с показателями краниальной миграции головки бедренной кости, угла сферичности ВВ в горизонтальной плоскости. Мета роботи – оцінювання стану кісткового масиву медіальної стінки ВЗ у проєкції імплантаційного ложа АК у нормі та при ДК, визначення цього взаємозв’язку з показниками сферичності та секторального дефіциту ВЗ, виходячи з даних МСКТ-морфометрії. Визначали товщину медіальної стінки ВЗ у проєкції ложа круглої зв’язки та зони імплантації АК згідно з запропонованою методикою; кореляцію з показниками краніальної міграції голівки стегнової кістки та кута сферичності ВЗ у горизонтальній площині.

Оригинальные исследования
Materials and methods
Results
Conclusions
Цель работы
Материалы и методы исследования
Исследуемый показатель
Proximal migration
Full Text
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