Three-Dimensional Geometric and Kinematic Measurement of Canine Hip Joint in Relation to Development of the Total Hip Replacement
Date Issued
2014
Date
2014
Author(s)
Wu, Ching-Ho
Abstract
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.
Subjects
髖關節發育不良
全人工髖關節
Norberg角度
擺位誤差
重複性分析
髖臼窩方位
限制型髖臼杯
運動範圍
犬
Type
thesis
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