Study of virtual reality technology combined with reduction plasty of femoral head in treatment of coxa plana_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

QIU Yue , XIA Tianwei , YUAN Zhaofeng , HUAN Dawei , ZHANG Chao ,  SHEN Jirong

Department of Traumatology & Orthopedics, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing Jiangsu, 210029, P. R. China;

Corresponding?author：

SHEN Jirong, Email: joint66118@sina.com

Keywords：

Virtual reality technology; reduction plasty of femoral head; coxa plana

DOI：

10.7507/1002-1892.202211098

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the feasibility of virtual reality (VR) technology combined with reduction plasty of the femoral head in the treatment of coxa plana and evaluate its effectiveness. Methods Three patients with coxa plana were selected as the research objects between October 2018 and October 2020, all of them were male, aged 15-24 years. Preoperative surgical planning was performed using VR technology; 256 rows of CT data of hip joint were imported into software to generate three-dimensional (3D) imaging, simulate the surgical process, and determine the matching relationship between the femoral head and acetabulum. According to the preoperative planning, reduction plasty of the femoral head under surgical dislocation, relative lengthening of the femoral neck, and periacetabular osteotomy were performed. The reduction of osteotomy size of femoral head and rotation angle of acetabulum were confirmed by C-arm fluoroscopy. The healing of the osteotomy were assessed by radiological examination after operation. The Harris score of hip function and visual analogue scale (VAS) score were recorded before and after operation. The femoral head roundness index, center-edge (CE) angle, and femoral head coverage were measured by X-ray films. Results Three operations were completed successfully, and the operation time was 460, 450, and 435 minutes, and the intraoperative blood loss was 733, 716, and 829 mL, respectively. All patients were infused with 3 U suspension oligoleucocyte and 300 mL frozen virus inactivated plasma after operation. No postoperative complication occurred, such as infection and deep vein thrombosis. Three patients were followed up 25, 30, and 15 months, respectively. CT showed good healing of the osteotomy at 3 months after operation. The VAS score and Harris score at 12 months after operation and at last follow-up, as well as the femoral head rounding index, hip CE angle, and femoral head coverage at 12 months after operation significantly improved when compared with those before operation; the hip function was evaluated by the Harris score at 12 months after operation, and all three patients were good. Conclusion VR technology combined with reduction plasty of the femoral head can achieve satisfactory short-term effectiveness in the treatment of coxa plana.

Citation： QIU Yue, XIA Tianwei, YUAN Zhaofeng, HUAN Dawei, ZHANG Chao, SHEN Jirong. Study of virtual reality technology combined with reduction plasty of femoral head in treatment of coxa plana. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(3): 284-289. doi: 10.7507/1002-1892.202211098 Copy

1.	Chaudhry S, Phillips D, Feldman D. Legg-Calvé-Perthes disease: an overview with recent literature. Bull Hosp Jt Dis (2013), 2014, 72(1): 18-27.
2.	Wenger DR, Pandya NK. A brief history of Legg-Calvé-Perthes disease. J Pediatr Orthop, 2011, 31(2 Suppl): S130-S136.
3.	Joseph B, Price CT. Principles of containment treatment aimed at preventing femoral head deformation in Perthes disease. Orthop Clin North Am, 2011, 42(3): 317-327.
4.	Ganz R, Horowitz K, Leunig M. Algorithm for femoral and periacetabular osteotomies in complex hip deformities. Clin Orthop Relat Res, 2010, 468(12): 3168-3180.
5.	Siebenrock KA, Anwander H, Zurmühle CA, et al. Head reduction osteotomy with additional containment surgery improves sphericity and containment and reduces pain in Legg-Calvé-Perthes disease. Clin Orthop Relat Res, 2015, 473(4): 1274-1283.
6.	鄭潮順, 李春海. 虛擬現實技術在骨科術前規劃中的應用. 中國骨科臨床與基礎研究雜志, 2017, 9(5): 310-315.
7.	Steppacher SD, Tannast M, Werlen S, et al. Femoral morphology differs between deficient and excessive acetabular coverage. Clin Orthop Relat Res, 2008, 466(4): 782-790.
8.	姜坤, 鮑琨. Perthes病的各治療方法原理及治療指征. 中華小兒外科雜志, 2015, 36(12): 948-952.
9.	Paley D. The treatment of femoral head deformity and coxa magna by the Ganz femoral head reduction osteotomy. Orthop Clin North Am, 2011, 42(3): 389-399.
10.	楊先騰, 張洪, 羅殿中, 等. 股骨頭縮小成形術治療大頭髖或扁平髖畸形的早期療效. 中華骨科雜志, 2017, 37(15): 942-951.
11.	羅殿中, 張洪. 一項基本的保髖手術技術: 髖關節外科脫位技術. 中華解剖與臨床雜志, 2015, (5): 475-480.
12.	Grzegorzewski A, Synder M, Koz?owski P, et al. The role of the acetabulum in Perthes disease. J Pediatr Orthop, 2006, 26(3): 316-321.
13.	Albers CE, Steppacher SD, Ganz R, et al. Impingement adversely affects 10-year survivorship after periacetabular osteotomy for DDH. Clin Orthop Relat Res, 2013, 471(5): 1602-1614.
14.	施樂, 樊燕鑫, 張超, 等. 虛擬現實技術術前規劃在經轉子間弧形內翻截骨術治療成人股骨頭缺血性壞死中的應用價值. 中國修復重建外科雜志, 2019, 33(8): 923-928.
15.	任鵬鵬, 張啟棟, 王衛國. 虛擬現實技術在骨科領域的研究進展. 中國矯形外科雜志, 2018, 26(21): 1980-1983.

1. Chaudhry S, Phillips D, Feldman D. Legg-Calvé-Perthes disease: an overview with recent literature. Bull Hosp Jt Dis (2013), 2014, 72(1): 18-27.
2. Wenger DR, Pandya NK. A brief history of Legg-Calvé-Perthes disease. J Pediatr Orthop, 2011, 31(2 Suppl): S130-S136.
3. Joseph B, Price CT. Principles of containment treatment aimed at preventing femoral head deformation in Perthes disease. Orthop Clin North Am, 2011, 42(3): 317-327.
4. Ganz R, Horowitz K, Leunig M. Algorithm for femoral and periacetabular osteotomies in complex hip deformities. Clin Orthop Relat Res, 2010, 468(12): 3168-3180.
5. Siebenrock KA, Anwander H, Zurmühle CA, et al. Head reduction osteotomy with additional containment surgery improves sphericity and containment and reduces pain in Legg-Calvé-Perthes disease. Clin Orthop Relat Res, 2015, 473(4): 1274-1283.
6. 鄭潮順, 李春海. 虛擬現實技術在骨科術前規劃中的應用. 中國骨科臨床與基礎研究雜志, 2017, 9(5): 310-315.
7. Steppacher SD, Tannast M, Werlen S, et al. Femoral morphology differs between deficient and excessive acetabular coverage. Clin Orthop Relat Res, 2008, 466(4): 782-790.
8. 姜坤, 鮑琨. Perthes病的各治療方法原理及治療指征. 中華小兒外科雜志, 2015, 36(12): 948-952.
9. Paley D. The treatment of femoral head deformity and coxa magna by the Ganz femoral head reduction osteotomy. Orthop Clin North Am, 2011, 42(3): 389-399.
10. 楊先騰, 張洪, 羅殿中, 等. 股骨頭縮小成形術治療大頭髖或扁平髖畸形的早期療效. 中華骨科雜志, 2017, 37(15): 942-951.
11. 羅殿中, 張洪. 一項基本的保髖手術技術: 髖關節外科脫位技術. 中華解剖與臨床雜志, 2015, (5): 475-480.
12. Grzegorzewski A, Synder M, Koz?owski P, et al. The role of the acetabulum in Perthes disease. J Pediatr Orthop, 2006, 26(3): 316-321.
13. Albers CE, Steppacher SD, Ganz R, et al. Impingement adversely affects 10-year survivorship after periacetabular osteotomy for DDH. Clin Orthop Relat Res, 2013, 471(5): 1602-1614.
14. 施樂, 樊燕鑫, 張超, 等. 虛擬現實技術術前規劃在經轉子間弧形內翻截骨術治療成人股骨頭缺血性壞死中的應用價值. 中國修復重建外科雜志, 2019, 33(8): 923-928.
15. 任鵬鵬, 張啟棟, 王衛國. 虛擬現實技術在骨科領域的研究進展. 中國矯形外科雜志, 2018, 26(21): 1980-1983.

Chinese Journal of Reparative and Reconstructive Surgery

Study of virtual reality technology combined with reduction plasty of femoral head in treatment of coxa plana

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content