Summary
Computed tomography (CT) with multiplanar reformation and three-dimensional (3D) image reconstruction was used pre-operatively to outline the bony morphological changes and femoral-acetabular relationships in 25 adult patients suffering from hip disease. Diagnoses included ischaemic necrosis of the femoral head, osteoarthritis, rheumatoid arthritis, calcium pyrophosphate dihydrate (CPPD) crystal deposition disease, previous trauma and chronic dislocation. Polyethylene models of the femora and acetabula were constructed from three-dimensional contouring of CT data and compared with resected specimens in patients subjected to subsequent total hip arthroplasty. Information provided by this imaging technique was useful in both selecting and guiding the most appropriate surgical procedure and it was found that models depicted the actual bony contours with reasonable accuracy. CT combined with multiplanar reformation and 3D analysis may be the optimal pre-operative means of assessment of the diseased adult hip.
Résumé
La tomodensitométrie (TDM) avec reconstruction multiple et tri-dimensionnelle (3 D) des images a été utilisée avant l'intervention afin de visualiser les modifications de la morphologie osseuse et les rapports entre le cotyle et la tête du fémur chez 25 sujets adultes présentant une hanche pathologique. Les diagnostics étaient nécrose de la tête fémorale, arthrose, arthrite rhumatoïde, chondrocalcinose, séquelles de traumatismes et de luxation congénitale. Des modèles en polyéthylène du fémur et du cotyle ont été réalisés à partir des données tri-dimensionnelles fournies par la TDM et comparées avec les pièces opératoires réséquées chez les patients traités par arthroplastie totale. Les informations apportées par cette technique d'imagerie ont été utiles à la fois pour indiquer et effectuer le meilleur procédé opératoire et on a trouvé que les modèles représentaient les véritables contours osseux avec une précision satisfaisante. La TDM avec reconstruction multiple et tri-dimensionnelle (3 D) pourrait être le meilleur moyen pré-opératoire d'évaluation d'une hanche pathologique chez l'adulte.
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Sartoris, D.J., Resnick, D., Bielecki, D. et al. Computed tomography with multiplanar reformation and three-dimensional image reconstruction in the preoperative evaluation of adult hip disease. International Orthopaedics 12, 1–8 (1988). https://doi.org/10.1007/BF00265734
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DOI: https://doi.org/10.1007/BF00265734