Kinematic study of a reconstructed hip in paediatric oncology.
In 1997, a large portion of the femur of a four-year-old child affected by a Ewing's sarcoma was reconstructed with an innovative technique that used a massive bone allograft, in conjunction with a vascularised fibula autograft that was directly articulated within the acetabulum. The aim of the present study was to assess the kinematic behaviour of the reconstructed hip during flexion, once the acute remodelling process observed after the operation had ceased. A few additional CT slices of the hip joint region, in a flexed position, were taken at month 33 of the follow-up. The helical axes relative to the neutral-flexion motor action were estimated: their relative positions, with respect to the anatomical femoral heads, were compared, and the translation of the anatomical head centres was estimated. The angles spanned by the two femurs were almost equal, as were the translations along the respective helical axis. The main difference between the two femurs was the distance between the estimated femoral head centres and the relative helical axes. This resulted in a non-negligible translation of 2.9 mm of the fibula head inside the acetabulum during flexion, significantly higher than the 0.5 mm found for the intact contralateral femur. The results showed that, although the transplanted fibula grew and remodelled during the follow up, the action of the reconstructed hip joint still cannot be described as a ball-and-socket.
Taddei
F
F
Laboratorio di Tecnologia Medica, Istituti Ortopedici Rizzoli, Bologna, Italy. taddei@tecno.ior.it
Stagni
A
A
Cappello
M
M
Manfrini
R
R
Albisinni
U
U
Viceconti
M
M
D001696:Biomechanical Phenomena; D016025:Bone Transplantation; D002675:Child, Preschool; D005260:Female; D005266:Femoral Neoplasms / Q000601:surgery*; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D023821:Limb Salvage / Q000534:rehabilitation; D016059:Range of Motion, Articular; D012512:Sarcoma, Ewing / Q000601:surgery*; D014057:Tomography, X-Ray Computed
Clin Orthop Relat Res. 1999 Jan;(358):111-9
9973982
Comput Methods Programs Biomed. 2003 Jun;71(2):117-27
12758133
Clin Biomech (Bristol, Avon). 1999 May;14 (4):227-35
10619110
IEEE Trans Med Imaging. 1998 Aug;17 (4):663-6
9845321
Lancet. 2003 Jan 11;361(9352):140-2
12531584
J Bone Joint Surg Br. 2000 Sep;82(7):1006-10
11041590
Proc Inst Mech Eng H. 2002;216(2):95-104
12022422
J Biomech. 1985;18(5):379-89
4008508
Clin Biomech (Bristol, Avon). 1995 Jun;10(4):171-178
11415549
Arch Orthop Trauma Surg. 1996;115(2):100-3
9063846
Proc Inst Mech Eng H. 2003;217(2):111-9
12666778
J Biomech. 1999 Jan;32(1):99-103
10050957
J Biomech. 1978;11(1-2):75-85
659458
J Biomech. 1995 Aug;28(8):995-8
7673267
Clin Orthop Relat Res. 1991 Mar;(264):156-68
1997230
J Biomech. 2000 Nov;33(11):1479-87
10940407
J Bone Joint Surg Am. 1986 Mar;68(3):362-9
3456348
J Bone Joint Surg Am. 1980 Jul;62(5):749-57
7391098
Med Inform Internet Med. 2002 Jun;27(2):71-83
12507267
Comput Methods Programs Biomed. 2001 Jun;65(3):175-82
11339979
Int Orthop. 2000;24(4):208-11
11081842
J Reconstr Microsurg. 1998 Feb;14(2):137-43
9524334