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Three-Dimensional Geometric and Kinematic Measurement of Canine Hip Joint in Relation to Development of the Total Hip Replacement
Dysplasia,Total hip replacement,Norberg angle,malposition,reliability,acetabulum orientation,constrained acetabular component,range of motion,canine,
|Publication Year :||2014|
研究結果顯示，(一) 在拍攝骨盆股骨腹背側X光影像的情況之下，增加骨盆向後傾斜的角度與股骨仰角將會量測得到一個增加的Norberg角度，組內和組間的量測重複性則是不論在何骨盆股骨擺位的情況下都相當高(ICC > 0.9)。(二) 本研究首次量測了以全人工髖關節設計與擺位為導向之天然髖關節三維型態學參數，並證明天然髖臼窩的角度與既有之人工髖關節製造商所提供之數據有差異，並且髖臼窩的幾何參數與犬隻的身長與身高並無關聯性。(三) 本研究成功設計並提出了一具備限制型態髖臼杯的全人工髖關節，透過電腦輔助手術模擬與分析，此人工髖關節被證明可提供拉不拉多犬足夠的屈曲、伸展、内收、外展與外轉的運動範圍。透過髖臼杯擺位誤差影響分析的結果顯示，正確的擺放髖臼杯的方位將是全人工髖關節滿足生活中所需之髖關節運動範圍的關鍵。
Canine hip dysplasia is a common disease in large-breed dogs, often diagnosed by using the Norberg angle (NA), an index for the laxity of the hip joint. Measurement of the NA may be affected by the pelvic and femoral positioning during imaging, the effects and test-retest reliability of which have not been documented. Therefore, for the 1st aim of study, an investigation on the influence of the malposition of bones on the NA measurement and its test-retest reliability was conducted by using synthetic radiographs generated at positions by combinations of five pelvic tilt angles and five femoral elevation angles.
Total hip replacement (THR) has been considered the most effective treatment option for treating dysplasia, advanced osteoarthritis or other disabling conditions of the hip in large breed dogs. However, a proportion of post-THR patients still inevitably suffer prosthesis dislocation for various reasons, which may be addressed by reinforcing the articulations of the THR. Among factors known to contribute to prosthesis dislocation, the orientation of the acetabular component has received much attention. Quantitative data of the three-dimensional morphology of the native normal acetabulum will be helpful for better design and implantation of prosthetic components. For the 2nd aim of the study, three-dimensional (3D) morphological parameters of the native acetabulum in Labrador Retriever dogs, including acetabular orientations and acetabular geometry, were measured using 3D CT computerized surface model. With the quantitative parameters of the acetabulum, the 3rd aims of the study were to propose a new THR with constrained acetabular component that aimed to decrease the incidence of postoperative dislocation while maintaining the necessary range of motion (ROM); and to evaluated for the ROM with and without malpositioning of the acetabular component.
It was concluded that (i) both the increase in caudal pelvic tilt and femoral elevation would increase the measured NA. The intra- and inter-examiner reliability was very good (ICC > 0.9) irrespective of the test positions. (ii) Three-dimensional morphological parameters of the native acetabulum in dogs were firstly reported in relation to the design and implantation of the THR. The native acetabular orientations were shown to be discrepant with manufactures’ recommendations, and the acetabular geometry did not correlate with the height and length of the body. (iii) A new THR with constrained acetabular cup was designed. From the computer-aided surgical simulations, the new THR was found to have sufficient functional ranges for flexion, extension, abduction, adduction and external rotation for Labrador Retrievers. Analysis of the malpositioning of the acetabular component suggests that accurate placement of the acetabular component is critical for achieving desirable ROM for daily activities.
|Appears in Collections:||臨床動物醫學研究所|
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