Abstract
In 1997, a large portion of the femur of a four-year-old child affected by a Ewing's sarcoma was reconstructed with an innovative technique that used a massive bone allograft, in conjunction with a vascularised fibula autograft that was directly articulated within the acetabulum. The aim of the present study was to assess the kinematic behaviour of the reconstructed hip during flexion, once the acute remodelling process observed after the operation had ceased. A few additional CT slices of the hip joint region, in a flexed position, were taken at month 33 of the follow-up. The helical axes relative to the neutral-flexion motor action were estimated: their relative positions, with respect to the anatomical femoral heads, were compared, and the translation of the anatomical head centres was estimated. The angles spanned by the two femurs were almost equal, as were the translations along the respective helical axis. The main difference between the two femurs was the distance between the estimated femoral head centres and the relative helical axes. This resulted in a non-negligible translation of 2.9 mm of the fibula head inside the acetabulum during flexion, significantly higher than the 0.5 mm found for the intact contralateral femur. The results showed that, although the transplanted fibula grew and remodelled during the follow up, the action of the reconstructed hip joint still cannot be described as a ball-and-socket.
Similar content being viewed by others
References
Andriacchi, T. P., Andersson, G. B., Fermier, R. W., Stern, D., andGalante, J. O. (1980): ‘A study of lower-limb mechanics during stair-climbing’,J. Bone Joint Surg. Am.,62, pp. 749–757
Andriacchi, T. P., andStrickland, A. B. (1983): Vol. Proc. NATO. Advanced Study Institute Biomechanics of Normal & Pathological Articulating Joints.Berme, N., Engin, A. E. andCorreira da Silva, K. M. (Eds.) Estoril, Portugal, pp. 83–102
Bell, A. L., Petersen, D. R., andBrand, R. A. (1989): ‘Prediction of hip joint centre location from external markers’,Hum. Mov. Sci.,8, pp. 3–16
Besl, P., andMcKay, N. (1992): ‘A method for registration of 3-D shapes’,IEEE Trans. Pattern Anal. Mach. Intell.,14, pp. 239–256
Bohm, P., Renner, E., andRossak, K. (1996): ‘Massive proximal femoral osteoarticular allograft’,Arch. Orthop. Trauma Surg.,115, pp. 100–103
Boissonnat, J.-D., andGeiger, B. (1993): inAcharya, R. S., andGoldgof, D. B. (Eds.): ‘Biomedical image processing and biomedical visualisation, vol. 1905’ Proc. Int. Soc. of Optical Engineering, (1993), pp. 964–975
Capanna, R., Bufalini, C., andCampanacci, M. (1993): ‘A new technique for reconstruction of large metadiaphyseal bone defects. A combined graft (allograft shell plus vascularised fibula)’,Ital. J. Orthop. Traumatol.,2, pp. 159–177
Cappozzo, A. (1984): ‘Gait analysis methodology’,Hum. Mov. Sci.,3, pp. 27–54
Cappozzo, A., Catani, F., Croce, U. D., andLeardini, A. (1995): ‘Position and orientation in space of bones during movement: anatomical frame definition and determination’,Clin. Biomech. (Bristol, Avon),10, pp. 171–178
Crowninshield, R. D., Johnston, R. C., Andrews, J. G., andBrand, R. A. (1978): ‘A biomechanical investigation of the human hip’,J. Biomech.,11, pp. 75–85
Davis III, R. B., Ounupuu, S., Tyburski, D., andGage, J. R. (1991): ‘A gait analysis data collection and reduction technique’,Hum. Mov. Sci.,10, pp. 575–587
Ilyas, I., Younge, D., Pant, R., andMoreau, P. (2000): ‘Limb salvage for proximal tibial tumours using a modular prosthesis’,Int. Orthop.,24, pp. 208–211
Innocenti, M., Ceruso, M., Manfrini, M., Angeloni, R., Lauri, G., Capanna, R., andBufalini, C. (1998): ‘Free vascularized growth-plate transfer after bone tumor resection in children’,J. Reconstr. Microsurg.,14, pp. 137–143
Kirkwood, R. N., Culham, E. G., andCostigan, P. (1999): ‘Radiographic and non-invasive determination of the hip joint center location: effect on hip joint moments’,Clin. Biomech. (Bristol, Avon),14, pp. 227–235
Lattanzi, R., Viceconti, M., Zannoni, C., Quadrani, P., andToni, A. (2002): ‘Hip-Op: an innovative software to plan total hip replacement surgery’,Med. Inform. Internet. Med.,27, pp. 71–83
Leardini, A., Cappozzo, A., Catani, F., Toksvig-Larsen, S., Petitto, A., Sforza, V., Cassanelli, G., andGiannini, S. (1999): ‘Validation of a functional method for the estimation of hip joint centre location’,J. Biomech.,32, pp. 99–103
Manfrini, M., Gasbarrini, A., Malaguti, C., Ceruso, M., Innocenti, M., Bini, S., Capanna, R., andCampanacci, M. (1999): ‘Intraepiphyseal resection of the proximal tibia and its impact on lower limb growth’,Clin. Orthop.,358, pp. 111–119
Manfrini, M., Innocenti, M., Ceruso, M., andMercuri, M. (2003): ‘Original biological reconstruction of the hip in a 4-year-old girl’,Lancet,361, pp. 140–142
Mercuri, M., Capanna, R., Manfrini, M., Bacci, G., Picci, P., Ruggieri, P., Ferruzzi, A., Ferraro, A., Donati, D., Biagini, R. De Maio, M., Cazzola, A., andCampanacci, M. (1991): ‘The management of malignant bone tumors in children and adolescents’,Clin. Orthop.,264, pp. 156–168
Popescu, F., Viceconti, M., Grazi, E., andCappello, A. (2003): ‘A new method to compare planned and achieved position of an orthopaedic implant’,Comput. Methods Progr. Biomed.,00, pp. 000-000
Rodl, R. W., Ozaki, T., Hoffmann, C., Bottner, F., Lindner, N., andWinkelmann, W. (2000): ‘Osteoarticular allograft in surgery for high-grade malignant tumours of bone’,J. Bone Joint Surg. Br.,82, pp. 1006–1010
Seidel, G. K., Marchinda, D. M., Dijkers, M., andSoutas-Little, R. W. (1995): ‘Hip joint center location from palpable bony landmarks—a cadaver study’,J. Biomech.,28, pp. 995–998
Shea, K. M., Lenhoff, M. W., Otis, J. C., andBackus, S. I. (1997): ‘Validation of a method for location of the hip joint centre’,Gait Posture,5, pp. 157–158
Stagni, R., Leardini, A., Cappozzo, A., Grazia, B. M., andCappello, A. (2000): ‘Effects of hip joint centre mislocation on gait analysis results’,J. Biomech.,33, pp. 1479–1487
Taddei, F., Viceconti, M., Manfrini, M., andToni, A. (2002): ‘Growth and remodelling of the autologous bone transplant used in a paediatric femoral reconstruction’,Proc. Inst. Mech. Eng. [H],216, pp. 95–104
Taddei, F., Viceconti, M., Manfrini, M., andToni, A. (2003): ‘Mechanical strength of a femoral reconstruction in paediatric oncology: a finite element study’,Proc. Inst. Mech. Eng. [H],217, pp. 111–119
Testi, D., Zannoni, C., Cappello, A., andViceconti, M. (2001): ‘Border-tracing algorithm implementation for the femoral geometry reconstruction’,Comput. Methods Programs Biomed.,65, pp. 175–182
Tylkowski, C. M., Simon, S. R., andMansour, J. M. (1982): ‘Internal rotation gait in spastic cerebral palsy in the hip’, Proc. 10th Open Scientific Meeting of Hip Society, Mosby, St.Louis
Winkelmann, W. W. (1986): ‘Hip rotationplasty for malignant tumors of the proximal part of the femur’,J. Bone Joint Surg. Am.,68, pp. 362–369
Woltring, H. J., Huiskes, R., de Lange, A., andVeldpaus, F. E. (1985): ‘Finite centroid and helical axis estimation from noisy landmark measurements in the study of human joint kinematics’,J. Biomech.,18, pp. 379–389
Zannoni, C., Cappello, A., andViceconti, M. (1998): ‘Optimal CT scanning plan for long-bone 3-D reconstruction’,IEEE Trans. Med. Imag.,17, pp. 663–666
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Taddei, F., Stagni, R., Cappello, A. et al. Kinematic study of a reconstructed hip in paediatric oncology. Med. Biol. Eng. Comput. 43, 102–106 (2005). https://doi.org/10.1007/BF02345129
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02345129