Can Computed Tomography Accurately Measure Acetabular Anterversion in Developmental Dysplasia of the Hip? Verification and Characterization Using 3D Printing Technology

Abstract Background: Accurate femoral neck anteversion angle (FNA) measurement is of great significance in the diagnosis and treatment of developmental dysplasia of the hip (DDH) in children. The FNA measurement still remains a controversy. We aimed to verify the accuracy of our CT method by 3D printing technology , and to evaluate its clinical value. Methods: Sixty-eight children with unilateral DDH were enrolled, and their FNA was measured using 2D-CT and 3D-CT, respectively, by three observers. This procedure was repeated 3 months later. The above measurement outcomes were then compared with the results in the 3D-printed femur (3D-PF) model. The FNA in the 3D-PF model was measured by three observers collectively through electronic angle instrument. Results: The primary measurement of FNA at the affected hips by 2D-CT was 44.0±6.1, 49.5±8.9 and 52.8±7.9 degrees, respectively. On the 3D-CT, it was 47.6±5.4, 49.3±6.8 and 48.6±6.2 degrees. Three months later, the FNA on 2D-CT was 49.3±10.5, 42.8±7.4 and 45.1±9.3 degrees, and it was 48.0±6.5, 48.9±7.2 and 49.0±5.7 degrees on 3D-CT, respectively. The FNA in the 3D-PF model at the affected and unaffected hips was 48.5±6.6 and 36.9±13.1 degrees. There were significant differences between 2D-CT and 3D-PF measurements, but no significant difference was found between 3D-CT and 3D-PF measurements. The results by 2D-CT showed significant differences among groups and between the groups. However, the results by 3D-CT had no significant differences among groups or between the groups. Conclusion: The results of our study showed that 3D-CT is a more precise, and reproducible method for FNA measurement in DDH. The FNA at the affected hips is 11.6 degree larger than the unaffected in DDH children aged 3-8 years.

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Accuracy of CT for measuring femoral neck anteversion in children with developmental dislocation of the hip verified using 3D printing technology

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02400-x ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Zhencun Cai ◽

Chengzhe Piao ◽

Tianyu Zhang ◽

Lianyong Li ◽

Liangbi Xiang

Keyword(s):

3D Printing ◽

Femoral Neck ◽

Developmental Dysplasia ◽

3D Ct ◽

Clinical Value ◽

Printing Technology ◽

3D Printing Technology ◽

Femoral Neck Anteversion ◽

Significant Difference ◽

3D Printed

Abstract Background Accurate femoral neck anteversion angle (FNA) measurement is of great significance in the diagnosis and treatment of developmental dysplasia of the hip (DDH) in children. The FNA measurement still remains a controversy. We aimed to verify the accuracy of our CT method by 3D printing technology and to evaluate its clinical value. Methods Sixty-eight children with unilateral DDH were enrolled, and their FNA was measured using 2D-CT and 3D-CT, respectively, by three observers. This procedure was repeated 3 months later. The above measurement outcomes were then compared with the results in the 3D-printed femur (3D-PF) model. The FNA in the 3D-PF model was measured by three observers (two radiologists and one orthopedist; all were professors) collectively through electronic angle instrument. Results The primary measurement of FNA at the affected hips by 2D-CT was 44.0 ± 6.1, 49.5 ± 8.9, and 52.8 ± 7.9°, respectively. On the 3D-CT, it was 47.6 ± 5.4, 49.3 ± 6.8, and 48.6 ± 6.2°. Three months later, the FNA on 2D-CT was 49.3 ± 10.5, 42.8 ± 7.4, and 45.1 ± 9.3°, and it was 48.0 ± 6.5, 48.9 ± 7.2, and 49.0 ± 5.7° on 3D-CT, respectively. The FNA in the 3D-PF model at the affected and unaffected hips was 48.5 ± 6.6 and 36.9 ± 13.1°. There were significant differences between 2D-CT and 3D-PF measurements, but no significant difference was found between 3D-CT and 3D-PF measurements. The results by 2D-CT showed significant differences among groups and between the groups. However, the results by 3D-CT had no significant differences among groups or between the groups. Conclusion The results of our study showed that 3D-CT is a more precise, and reproducible method for FNA measurement in DDH. The FNA at the affected hips is 11.6° larger than the unaffected in DDH children aged 3–8 years.

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