Abstract:In theory, a hemispherical acetabulum provides the ideal hip congruity in any hip position. However, it remains unknown how the three‐dimensional acetabular morphology of borderline dysplastic and frank dysplastic hips compare to normal hips. This study inquires if borderline dysplastic zonal‐acetabular curvatures in the anterior, superior, and posterior zones are different from normal or dysplastic hips three‐dimensionally. One‐hundred and fifteen hips, grouped as control (25°≤ LCEA <40°), 36 hips; borderline… Show more
“…Three-dimensional images of the radius, ulna, scaphoid, and lunate were reconstructed, and the resulting 3D models were then exported as pointcloud and polygon models using the same software package. The 3D radius, ulna, scaphoid, and lunate bone models were then analyzed with custom-written software created using Microsoft Visual C + + in the Microsoft Foundation Class programming environment (Microsoft, Redmond, WA) for further analysis 11 – 13 .…”
We hypothesized that the contact area of the articular surface of the wrist joint could be evaluated using a custom-designed analytical program. The aim of the study was to compare the articular contact area of the wrist joint before and after radial shortening osteotomy for Kienböck’s disease. Nine wrists of 9 patients underwent radial shortening osteotomy for Kienböck’s disease. Computed tomography (CT) images of the wrist joint were reconstructed using a 3D reconstruction software package. Radioscaphoid and radiolunate joint contact areas and translation of the joint contact area from preoperative to postoperative were calculated using customized software. The mean Modified Mayo Wrist Score was significantly improved from 50.6 preoperatively to 83.3 at final follow-up (p < .001). Preoperatively, the pain was reported as severe in five wrists and moderate in four wrists, while at final follow-up, five patients were free from pain and four patients had mild pain with vigorous activity. The preoperative radioscaphoid joint contact area was 133.4 ± 49.5 mm2 and the postoperative radioscaphoid joint contact area was 156.4 ± 73.1 mm2. The preoperative radiolunate joint contact area was 194.8 ± 92.1 mm2 and the postoperative radiolunate joint contact area was 148.3 ± 97.9 mm2. The radial translation distance was 0.4 ± 1.2 mm, the dorsal translation distance was 0.6 ± 1.2 mm, and the proximal translation distance was 0.2 ± 0.4 mm. CT-based analysis revealed that the center of the contact area translated radially following radial shortening.
“…Three-dimensional images of the radius, ulna, scaphoid, and lunate were reconstructed, and the resulting 3D models were then exported as pointcloud and polygon models using the same software package. The 3D radius, ulna, scaphoid, and lunate bone models were then analyzed with custom-written software created using Microsoft Visual C + + in the Microsoft Foundation Class programming environment (Microsoft, Redmond, WA) for further analysis 11 – 13 .…”
We hypothesized that the contact area of the articular surface of the wrist joint could be evaluated using a custom-designed analytical program. The aim of the study was to compare the articular contact area of the wrist joint before and after radial shortening osteotomy for Kienböck’s disease. Nine wrists of 9 patients underwent radial shortening osteotomy for Kienböck’s disease. Computed tomography (CT) images of the wrist joint were reconstructed using a 3D reconstruction software package. Radioscaphoid and radiolunate joint contact areas and translation of the joint contact area from preoperative to postoperative were calculated using customized software. The mean Modified Mayo Wrist Score was significantly improved from 50.6 preoperatively to 83.3 at final follow-up (p < .001). Preoperatively, the pain was reported as severe in five wrists and moderate in four wrists, while at final follow-up, five patients were free from pain and four patients had mild pain with vigorous activity. The preoperative radioscaphoid joint contact area was 133.4 ± 49.5 mm2 and the postoperative radioscaphoid joint contact area was 156.4 ± 73.1 mm2. The preoperative radiolunate joint contact area was 194.8 ± 92.1 mm2 and the postoperative radiolunate joint contact area was 148.3 ± 97.9 mm2. The radial translation distance was 0.4 ± 1.2 mm, the dorsal translation distance was 0.6 ± 1.2 mm, and the proximal translation distance was 0.2 ± 0.4 mm. CT-based analysis revealed that the center of the contact area translated radially following radial shortening.
“…Three-dimensional images of the humerus, radius, and ulna were reconstructed, and the resulting 3D models were then exported as pointcloud and polygon models using the same software package. The 3D humerus, radius, and ulna bone models were then analyzed with custom-written software created using Microsoft Visual C++ with the Microsoft Foundation Class programming environment (Microsoft, Redmond, WA, USA) for further analysis 21 – 23 . Figure 4 Acquisition of 3D bone models.…”
The aim of this study was to evaluate the joint contact area of the dominant side and that of the non-dominant side without valgus instability in symptomatic pitchers. Ten symptomatic elbow medial ulnar collateral ligament (UCL) deficient baseball pitchers participated in this study. Computed tomography (CT) data from the dominant and non-dominant elbows were obtained with and without elbow valgus stress. The CT imaging data of each elbow joint were reconstructed using a 3D reconstruction software package, and the radiocapitellar and ulnohumeral joint contact areas were calculated. The center of the contact area and the translation from the position without stress to the position with valgus stress were also calculated. With elbow valgus stress, the contact area changed, and the center of the radiocapitellar joint contact area translated significantly more laterally in the dominant elbow than in the non-dominant elbow (p = 0.0361). In addition, the center of the ulnohumeral joint contact area translated significantly more posteriorly in the dominant elbow than in the non-dominant elbow (p = 0.0413). These changes in contact areas could be the reason for cartilage injury at the posterior trochlea in pitchers with UCL deficiency.
“…Is there a better way to intraoperatively replicate a weightbearing load with rotation, cutting, or pivoting? Fourth, admittedly the hip joint is an incredibly complex 3-dimensional structure, but joint congruity (matching acetabular concavity and femoral head convexity) 10,11 has not been measured relative to the role of the labrum and clinical outcomes. It is the unusual situation of an absent labrum with a "normal" seal or a normal labrum without a seal (e.g., mildly everted or hypotrophic labrum 12 ) in which the role of joint congruity could provide answers.…”
Section: See Related Article On Page 352mentioning
One of the core principles of hip arthroscopy is preservation of the acetabular labrum. Compromise of the biomechanical function of the labrum underlies a significant symptom source in patients undergoing hip preservation surgery. As surgical techniques continue to improve and evolve beyond labral repair, increased use of advanced arthroscopic procedures like segmental and circumferential reconstruction shed further light on the optimal labral intervention. In the revision setting, labral deficiency warrants labral reconstruction or augmentation. Both segmental and circumferential techniques may significantly improve patient-reported outcomes. However, in the primary setting, controversy exists not necessarily in the surgical technique, but more in the indications to perform which specific labral intervention. Reasonable indications for primary labral reconstruction include a calcified or ossified labrum, irreparable labral tissue, and hypotrophy of the labrum (less than 2-3 mm) with a proven deficient suction seal without resistance to axial distraction. Short-term multicenter studies demonstrate similar success rates between primary labral reconstruction and repair using validated patient-report outcome scores. Mid-and long-term clinical and economic investigations comparing labral reconstruction and repair are needed to determine the role of primary reconstruction in modern arthroscopic hip preservation surgery.
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