1.Expert Consensus on the Technical Process for Preoperative Three-Dimensional Planning of Total Hip Arthroplasty Using a Dual Fluoroscopic Imaging System(2024 Version)
Juan WANG ; Huiwu LI ; Pei YANG ; Li CAO ; Yunsu CHEN ; Eryou FENG ; Zhenpeng GUAN ; Wei HUANG ; Pengfei LEI ; Chunbao LI ; Pingyue LI ; Xiaoming LI ; Zhitao RAO ; Hua TIAN ; Peijian TONG ; Fei WANG ; Guangji WANG ; Liao WANG ; Wei WANG ; Yayi XIA ; Peng XU ; Qi YAO ; Tengbo YU ; Guoqiang ZHANG ; Zongke ZHOU ; Kunzheng WANG ; Tsungyuan TSAI ; Zhiyong HOU
Journal of Medical Biomechanics 2024;39(6):1016-1025
Total hip arthroplasty(THA)is an effective treatment for elderly femoral neck fractures,mid-to late-stage femoral head necrosis,and end-stage hip osteoarthritis.However,serious complications such as aseptic loosening of the prosthesis,peripheral fractures,and dislocation of the prosthesis still exist following THA,which makes the selection of the appropriate hip prosthesis type and placement position before THA an important challenge for surgeons.Currently,the commonly used preoperative planning methods for THA mainly rely on static images from two-dimensional(2D)X-ray or three-dimensional(3D)computed tomography(CT),which fail to adequately consider the hip joint in weight-bearing as well as motion,lumbar-hip joint changes,and prosthetic impingement during motion.Recently,the dual fluoroscopic imaging system,as a new in-vivo,dynamic radiological imaging technology,provides comprehensive and accurate dynamic 3D data for THA preoperative planning.However,the technical process and expert consensus on preoperative 3D planning of THA using a dual fluoroscopic imaging system have not yet been established,which affects the promotion and application of this technology.In light of the above,national orthopaedic experts and related professional representatives discussed and proposed seven consensus issues,and the'expert recommendation rate'and'strong recommendation rate'were obtained through a questionnaire survey on the recommendations of the participating experts.This consensus aims to provide guidance and reference for the standardised application of preoperative 3D planning of THA using the dual fluoroscopic imaging system.
2.Expert Consensus on the Technical Process for Preoperative Three-Dimensional Planning of Total Hip Arthroplasty Using a Dual Fluoroscopic Imaging System(2024 Version)
Juan WANG ; Huiwu LI ; Pei YANG ; Li CAO ; Yunsu CHEN ; Eryou FENG ; Zhenpeng GUAN ; Wei HUANG ; Pengfei LEI ; Chunbao LI ; Pingyue LI ; Xiaoming LI ; Zhitao RAO ; Hua TIAN ; Peijian TONG ; Fei WANG ; Guangji WANG ; Liao WANG ; Wei WANG ; Yayi XIA ; Peng XU ; Qi YAO ; Tengbo YU ; Guoqiang ZHANG ; Zongke ZHOU ; Kunzheng WANG ; Tsungyuan TSAI ; Zhiyong HOU
Journal of Medical Biomechanics 2024;39(6):1016-1025
Total hip arthroplasty(THA)is an effective treatment for elderly femoral neck fractures,mid-to late-stage femoral head necrosis,and end-stage hip osteoarthritis.However,serious complications such as aseptic loosening of the prosthesis,peripheral fractures,and dislocation of the prosthesis still exist following THA,which makes the selection of the appropriate hip prosthesis type and placement position before THA an important challenge for surgeons.Currently,the commonly used preoperative planning methods for THA mainly rely on static images from two-dimensional(2D)X-ray or three-dimensional(3D)computed tomography(CT),which fail to adequately consider the hip joint in weight-bearing as well as motion,lumbar-hip joint changes,and prosthetic impingement during motion.Recently,the dual fluoroscopic imaging system,as a new in-vivo,dynamic radiological imaging technology,provides comprehensive and accurate dynamic 3D data for THA preoperative planning.However,the technical process and expert consensus on preoperative 3D planning of THA using a dual fluoroscopic imaging system have not yet been established,which affects the promotion and application of this technology.In light of the above,national orthopaedic experts and related professional representatives discussed and proposed seven consensus issues,and the'expert recommendation rate'and'strong recommendation rate'were obtained through a questionnaire survey on the recommendations of the participating experts.This consensus aims to provide guidance and reference for the standardised application of preoperative 3D planning of THA using the dual fluoroscopic imaging system.
3.Systematic Review on Studies of in vivo Patellofemoral Joint Kinematics
Journal of Medical Biomechanics 2021;36(4):E664-E670
Patellar tracking disorder is recognized as one of the major causes of the pathophysiological mechanism in patellofemoral pain syndrome. This paper reviewed the results of patellofemoral kinematic analyses and summarized the motion characteristics of six-degrees-of-freedom (6DOF) of patellofemoral joints under different functional activities. Patella has a relatively unified trend in lateral, anterior and posterior translation, tilt and flexion. However, different measurements limit an in-depth comparison between studies. In the future, widely applying magnetic resonance(MRI) or/and dual fluoroscopic imaging system (DFIS), standardizing the establishment of coordinate system or definition and use of morphological parameters, and increasing sample size will contribute to explicating the 6DOF motion characteristics of patellofemroal joints in vivo and improve the clinical evaluation on kinematic function of patellofemroal joints.
4.In vivo Kinematic Characteristics of the Elbow during Active Flexion-Extension Motion Using Dual Fluoroscopic Imaging System
Diyang ZOU ; Xiangjun HU ; Hai HU ; Weihua GONG ; Tsungyuan TSAI
Journal of Medical Biomechanics 2020;35(5):E622-E628
Objective To investigate the translation and rotation of healthy elbow joints during active flexion and extension, so as to provide references for the treatment of elbow instability and injuries. Methods Ten healthy subjects with no history of upper extremity trauma were recruited. Dual fluoroscopic imaging system (DFIS) was applied to quantify six-degree-of-freedom (6-DOF) kinematics of humeroulnar and humeroradial joint from full extension to maximum flexion in supination position. Correlation analysis was used to evaluate the relationship between the 6-DOF kinematics of the elbow joint. Results Valgus angle of humeroulnar joint gradually decreased from 15.2°±3.1° to 5.3°±2.3° with the flexion increasing. Valgus angle of humeroradical joint gradually decreased from 19.7°±4.2° to 8.2°±2.4° from full extension to maximum flexion. The valgus angle of humeroulnar and humeroradial joint was linearly related to the flexion angle during flexion and extension. The internal rotation of humeroulnar joint was quadratic nonlinearly related to the flexion angle during motion. The maximum internal rotation of the ulnar was 4.0°±4.9° at 110° flexion, and the maximum external rotation was 5.1°±4.2°. The internal rotation of humeroulnar joint gradually increased from 3.2°±16.0° to 27.2°±18.0°. Conclusions During normal flexion and extension of the elbow, the valgus angle of humeroulnar joint decreased linearly, while the internal and external rotation angle showed a nonlinear change, which first rotated internally and then rotated externally. The valgus angle of humeroradial joint decreased linearly and the internal rotation angle increased linearly. Therefore, humeroulnar joint is not a hinge joint during elbow flexion and extension. There is a kinematic difference between humeroulnar joint and humeroracial joint. For clinical treatment of complex elbow injuries, elbow instability and elbow replacement, different motion characteristics in joints should be considered to improve the outcome after surgery.

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