Validation of a computerized model for a new biomechanical concept- the fossa-foveolar mismatch- the answer to lesions of the ligamentous fossa-foveolar complex in the hip?
DOKPE
- Stetzelberger, Vera M. ORCID HFR Cantonal Fribourg, University of Fribourg
- Segessenmann, Jannine T. HFR Cantonal Fribourg, University of Fribourg
- Cek, Cem HFR Cantonal Fribourg, University of Fribourg
- Popa, Vlad ORCID HFR Cantonal Fribourg, University of Fribourg
- Schwab, Joseph M. ORCID HFR Cantonal Fribourg, University of Fribourg
- Zurmühle, Corinne A. HFR Cantonal Fribourg, University of Fribourg
- Heimann, Alexander F. ORCID HFR Cantonal Fribourg, University of Fribourg
- Tannast, Moritz ORCID HFR Cantonal Fribourg, University of Fribourg
- 2024
Published in:
- Archives of Orthopaedic and Trauma Surgery. - London, UK: Springer Nature. - 2024
Fossa-foveolar mismatch
Hip preserving surgery
Ligamentum teres
Hip pain
Acetabular fossa
Fovea capitis
Intraclass correlation coefficient
Range of motion
Hip morphology
Hip
Active patients
Validation
Biomechanical
3D model
CT
English
Background: Hip-preserving surgery in young patients frequently reveals lesions of the ligamentum teres (LT). Histological and clinical evidence supports that those lesions could be source of intraarticular hip pain. It has been hypothesized that LT degeneration could be linked to the abnormal positioning of the fovea outside the lunate surface during various daily motions. We introduce the “fossa-foveolar mismatch” (FFM) by determining the trajectory of the fovea in the fossa during hip motions, enabling a comparison across diverse hip-pathomorphologies. Aims: to determine (1) intraobserver reliability and (2) interobserver reproducibility of our computer-assisted 3-dimensional (3D) model of the FFM.
Materials and methods: All patients with joint preserving surgery for femoroacetabular impingement syndrome (FAIS) or developmental dysplasia of the hip (DDH) at our institution (11. 2015–08.2019) were initially eligible. We employed a simple random sampling technique to select 15 patients for analysis. Three-dimensional surface models based on preoperative computed tomography (CT) scans were built, the fossa virtually excised, the fovea capitis marked. Models were subjected to physiological range of motion with validated 3D collision detection software. Using a standardized medial view on the resected fossa and the transparent lunate surface, the FFM-index was calculated for 17 motions. It was obtained by dividing the surface occupied by the fovea outside of the fossa by the total foveolar tracking surface. Three observers independently performed all analyses twice. (1) Intraobserver reliability and (2) interobserver reproducibility were calculated using intraclass correlation coefficients (ICCs).
Results: (1) We obtained excellent intraobserver ICCs for the FFM-index averaging 0.92 with 95% CI 0.77–0.9 among the three raters for all motions. (2) Interobserver reproducibility between raters was good to excellent, ranging from 0.76 to 0.98.
Conclusions: The FFM-index showed excellent intraobserver reliability and interobserver reproducibility for all motions. This innovative approach deepens our understanding of biomechanical implications, providing valuable insights for identifying patient populations at risk.
Materials and methods: All patients with joint preserving surgery for femoroacetabular impingement syndrome (FAIS) or developmental dysplasia of the hip (DDH) at our institution (11. 2015–08.2019) were initially eligible. We employed a simple random sampling technique to select 15 patients for analysis. Three-dimensional surface models based on preoperative computed tomography (CT) scans were built, the fossa virtually excised, the fovea capitis marked. Models were subjected to physiological range of motion with validated 3D collision detection software. Using a standardized medial view on the resected fossa and the transparent lunate surface, the FFM-index was calculated for 17 motions. It was obtained by dividing the surface occupied by the fovea outside of the fossa by the total foveolar tracking surface. Three observers independently performed all analyses twice. (1) Intraobserver reliability and (2) interobserver reproducibility were calculated using intraclass correlation coefficients (ICCs).
Results: (1) We obtained excellent intraobserver ICCs for the FFM-index averaging 0.92 with 95% CI 0.77–0.9 among the three raters for all motions. (2) Interobserver reproducibility between raters was good to excellent, ranging from 0.76 to 0.98.
Conclusions: The FFM-index showed excellent intraobserver reliability and interobserver reproducibility for all motions. This innovative approach deepens our understanding of biomechanical implications, providing valuable insights for identifying patient populations at risk.
- Faculty
- Faculté des sciences et de médecine
- Department
- Department of Orthopaedic Surgery and Traumatology, HFR Cantonal Hospital
- Language
-
- English
- Classification
- Pathology, clinical medicine
- License
- CC BY
- Open access status
- hybrid
- Identifiers
-
- DOI 10.1007/s00402-024-05508-x
- ISSN 1434-3916
- ISSN 0936-8051
- Persistent URL
- https://folia.unifr.ch/unifr/documents/329858
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