Analysis of secondary coxarthrosis by three dimensional computed tomography

The majority of coxarthrosis in Japan is due to congenital dislocation of the hip and acetabular dysplasia. Until now coxarthrosis has been chiefly analyzed on the basis of anterior-posterior radiographs. By using three-dimensional (3D) CT, it was possible to analyze the morphological features of secondary coxarthrosis more accurately, and by using new computer graphics software, it was possible to display the contact area in the hip joint and observe changes associated with progression of the stages of the disease. There were 34 subjects (68 joints), and all of who were women. The CT data were read into a work station, and 3D reconstruction was achieved with hip surgery simulation software (SurgiPlan). Pelvic inclination, acetabular anteversion, seven parameters indicating the investment of the femoral head and two indicating the position of the hip joint in the pelvis were measured. The results showed that secondary coxarthrosis is characterized not only by lateral malposition of the hip joint according to the pelvic coordinates, but by anterior malposition as well. Many other measurements provided 3D information on the acetabular dysplasia. Many of them were correlated with the CE angle on plain radiographs. Furthermore, a strong correlation was not found between anterior and posterior acetabular coverage of the femoral head. In addition, SurgiPlan's distance mapping function enabled 3D observation of the pattern of progression of arthrosis based on the pattern of progression of joint space narrowing. (author)