基于3D重建技术探讨发育性髋关节发育不良患者膝关节形态差异

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Abstract

Objective To explore the differences in knee joint parameters among developmental dysplasia of the hip (DDH) patients through 3D reconstruction technology，providing data reference for hip and knee surgery in DDH patients.Methods From January 2019 to December 2022，127 DDH patients were prospectively recruited，including 98 cases in the unilateral DDH group，29 cases (58 knees) in the bilateral DDH group，and 110 cases in the control group (healthy individuals).28 males and 70 females were included in the unilateral DDH group.The average age was (35.40±11.62) years old.There were 7 males and 22 females in the bilateral DDH group.The average age was (36.17±12.58) years old.32 males and 78 females were included in the control group.The average age is (35.82±11.49) years old.We collected CT data from three groups of patients for 3D reconstruction，and measure knee joint related parameters based on the 3D reconstruction model，including width of medial femoral condyle(WMFC)，width of lateral femoral condyle(WLFC)，height of medial femoral condyle(HMFC)，height of lateral femoral condyle(HLFC)，and width of medial tibial platform(WMTP) Width of lateral tibial platform(WLTP)，femoral anterior joint edge distance(FAJED)，femoral posterior joint edge distance(FPJED)，tibial anterior joint edge distance(TAJED)，and tibial posterior joint edge distance(TPJED)，femorofemoral angle(FTA)，lateral distal femoral angle(LDFA)，medial proximal tibial angle(MPTA)，posterior posterior tibial angle(PPTA)，and posterior posterior femoral angle(PDFA).The knee joint orthographies and angle related parameters were compared.Results The WLFC，WLTP，and LDFA in the control group were significantly higher than those in the unilateral DDH group and bilateral DDH group(P＜0.05)，while the WLFC，WLTP，and LDFA in the unilateral DDH group were significantly higher than those in the bilateral DDH group(P＜0.05).The HMFC of the control group was significantly smaller than that of the unilateral DDH group and bilateral DDH group(P＜0.05)，and the HMFC of the bilateral DDH group was greater than that of the unilateral DDH group(P＜0.05).The WMTP of the control group was significantly lower than that of the unilateral DDH group(P＜0.05)，and the WMTP of the unilateral DDH group was significantly higher than that of the bilateral DDH group(P＜0.05).There was no statistically significant difference in WMTP between the bilateral DDH group and the control group(P＞0.05).There was no statistically significant difference(P＞0.05) in the comparison of three groups of WMFC，HLFC，and MPTA.The difference in FTA among the three groups was statistically significant(P＜0.05)，and the FTA of the control group was significantly smaller than that of the unilateral DDH group and the bilateral DDH group(P＜0.05).In addition，there was a statistically significant difference in FAJED，PDFA，and PPTA among the three groups(P＜0.05).The FAJED，PDFA，and PPTA in the control group were significantly higher than those in the unilateral DDH group and bilateral DDH group(P＜0.05).The FAJED and PDFA in the unilateral DDH group were significantly higher than those in the bilateral DDH group(P＜0.05).The FPJED of the control group was significantly higher than that of the unilateral DDH group，and there was no statistically significant difference in FPJED between the bilateral DDH group and the unilateral DDH group(P＞0.05).Furthermore，there was a statistically significant difference in TAJED among the three groups(P＜0.05).The TAJED of the unilateral DDH group was significantly lower than that of the control group and the bilateral DDH group(P＜0.05).There was no statistically significant difference in TPJED among the three groups(P＞0.05).Conclusion DDH patients have an increase in knee valgus angle，which is related to an increase in HMFC.DDH patients have reduced distal femoral posterior angle and proximal tibial posterior angle in the knee joint.The severity of acetabular dysplasia is related to knee valgus and posterior tibial tilt.

Key words： developmental dysplasia of the hip joint knee joint valgus 3 dimension image

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