Computer-Assisted Optimization of the Acetabular Rotation in Periacetabular Osteotomy Using Patient’s Anatomy-Specific Finite Element Analysis

Park, Sungjae; Lee, Sung-Jae; Chen, Wen Ming; Park, Jung-Hong; Cho, Yong-Soo; Shin, Taejin; Kwon, Soon-Yong

doi:10.1155/2018/9730525

Cited by 5 publications

(7 citation statements)

References 35 publications

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“…During the reorientation process of PAO, the first step is to achieve sufficient lateral coverage through coronal correction and the second step is to achieve sufficient anterior coverage through anterior rotation [9,43]. Although several finite-element analysis studies have considered multiplanar correction including the coronal and sagittal planes [27,36,56], no appropriate algorithm has been established for effectively combining sagittal and coronal acetabular correction to optimize the joint contact mechanics. A previous study using theoretical models demonstrated that anterolateral rotation of the acetabular fragment was more effective in reducing contact pressure than lateral rotation alone [15].…”

Section: Does Additional Anterior Rotation Of the Acetabular Fragment...mentioning

confidence: 99%

Is Anterior Rotation of the Acetabulum Necessary to Normalize Joint Contact Pressure in Periacetabular Osteotomy? A Finite-element Analysis Study

Kitamura

Fujii

Iwamoto

et al. 2021

Clin Orthop Relat Res

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Background Inappropriate sagittal plane correction can result in an increased risk of osteoarthritis progression after periacetabular osteotomy (PAO). Individual and postural variations in sagittal pelvic tilt, along with acetabular deformity, affect joint contact mechanics in dysplastic hips and may impact the direction and degree of acetabular correction. Finite-element analyses that account for physiologic pelvic tilt may provide valuable insight into the effect of PAO on the contact mechanics of dysplastic hips, which may lead to improved acetabular correction during PAO.Questions/purposes We performed virtual PAO using finite-element models with reference to the standing pelvic position to clarify (1) whether lateral rotation of the acetabulum normalizes the joint contact pressure, (2) risk factors for abnormal contact pressure after lateral rotation of the acetabulum, and (3) whether additional anterior rotation of the acetabulum further reduces contact pressure.Methods Between 2016 and 2020, 85 patients (92 hips) underwent PAO to treat hip dysplasia. Eighty-two patients with hip dysplasia (lateral center-edge angle < 20°) were included. Patients with advanced osteoarthritis, femoral head deformity, prior hip or spine surgery, or poor-quality images were excluded. Thirty-eight patients (38 hips) were eligible to participate in this study. All patients were women, with a mean age of 39 6 10 years. Thirty-three women volunteers without a history of hip disease were reviewed as control participants. Individuals with a lateral center-edge angle < 25°or poor-quality images were excluded. Sixteen individuals (16 hips) with a mean age of 36 6 7 years were eligible as controls. Using CT images, we developed patient-specific three-dimensional surface hip models with the standing pelvic position as a reference. The loading scenario was based on single-leg stance. Four patterns of virtual PAO were performed in the models. First, the acetabular fragment was rotated laterally in the coronal plane so that the lateral center-edge angle was 30°; then, anterior rotation in the sagittal plane was added by 0°, 5°, 10°, and 15°. We developed finite-element models for each acetabular position and performed a nonlinear contact analysis to calculate the joint contact pressure of the acetabular cartilage. The normal range of the maximum joint contact pressure was calculated to be < 4.1 MPa using a receiver operating characteristic curve. A paired t-test or This work was supported by a Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (No. JP18K09109, JP21K09281). Each author certifies that there are no funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article related to the author or any immediate family members. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research® editors and board members are on file with ...

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Section: Does Additional Anterior Rotation Of the Acetabular Fragment...mentioning

confidence: 99%

Is Anterior Rotation of the Acetabulum Necessary to Normalize Joint Contact Pressure in Periacetabular Osteotomy? A Finite-element Analysis Study

Kitamura

Fujii

Iwamoto

et al. 2021

Clin Orthop Relat Res

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“…Referring to the reported boundary conditions, all displacements of the sacroiliac side, pubic symphysis, and distal femur were constrained, and the displacements and rotations in all directions were zero [ 20 ]. The contact between the femoral proximal end and the acetabular cartilage is defined as the contactless surface.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of the short-term curative effect of closed reduction in the treatment of developmental dysplasia of the hip based on three-dimensional magnetic resonance imaging finite element analysis

Liu

Gao

et al. 2022

BMC Musculoskelet Disord

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Background Based on the Digital Imaging and Communications in Medicine (DICOM) data of three-dimensional magnetic resonance imaging (3D-MRI), finite element models of the hip joints of children with developmental dysplasia of the hip were established. The primary objectives included simulation and analysis of the finite element model pre- and post-closed reduction under different stances and loads, and evaluation of the size and distribution of von Mises stress in the acetabulum and femoral head pre- and post-operation and the short-term effects. Methods Acetabular index measurements of both the unaffected and affected sides were conducted, alongside International Hip Dysplasia Institute (IHDI) classification of the affected hip. Establishing the finite element model of both the affected and unaffected hips was based on the 3D-T1WI sequence DICOM data, using Mimics, 3-matic, and Ansys software, before and after closed reduction surgery. The size and distribution data of von Mises stress on the affected side of the acetabulum and femoral head were collected pre- and post-operation. Results The study indicated that the increasing acetabular index of the affected hip was directly proportional to the increasing severity based on IHDI classification (P < 0.05). Preoperative IHDI classification significantly correlated with the von Mises stress (r = 0.560–0.569, 0.562–0.564, P < 0.05). Under different stances and load conditions, the von Mises stress on the affected side post-operation was lower than that noted pre-operation (P < 0.01), while that on the acetabulum increased proportionally to the load. Although the magnitude and distribution of von Mises stress on the affected side of the acetabulum were similar to those on the healthy side post-operation, there were statistical differences between the two (P < 0.01). The von Mises stress of the lateral column of the femoral head post-operation was significantly lower than that noted pre-operation (P < 0.01). While the high-stress points of the lateral column disappeared post-operation, the von Mises stress was evenly distributed in the femoral head. Conclusions The 3D-MRI finite element could provide the von Mises stress value and distribution characteristics of the acetabulum and femoral head pre- and post-operation. Closed reduction can, therefore, improve the size and distribution of von Mises stress on the affected acetabulum and femoral head.

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“…Let’s start considering the first question: Restriction of hip motion in flexion and internal rotation can be clinically relevant in the presence of subspinous extraarticular impingement. Finite element analysis (FEA) and ROM computational simulation of common dysplastic hip models with different AIIS shapes can help identify at-risk morphologies [5]. These simulations could be performed using the Type 3 classification of AIIS morphology proposed in the present study.…”

Section: How Do We Get There?mentioning

confidence: 99%

CORR Insights®: Prominent Anterior Inferior Iliac Spine Morphologies Are Common in Patients with Acetabular Dysplasia Undergoing Periacetabular Osteotomy

Pitto

2021

Clin Orthop Relat Res

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Computer-Assisted Optimization of the Acetabular Rotation in Periacetabular Osteotomy Using Patient’s Anatomy-Specific Finite Element Analysis

Cited by 5 publications

References 35 publications

Is Anterior Rotation of the Acetabulum Necessary to Normalize Joint Contact Pressure in Periacetabular Osteotomy? A Finite-element Analysis Study

Is Anterior Rotation of the Acetabulum Necessary to Normalize Joint Contact Pressure in Periacetabular Osteotomy? A Finite-element Analysis Study

Evaluation of the short-term curative effect of closed reduction in the treatment of developmental dysplasia of the hip based on three-dimensional magnetic resonance imaging finite element analysis

CORR Insights®: Prominent Anterior Inferior Iliac Spine Morphologies Are Common in Patients with Acetabular Dysplasia Undergoing Periacetabular Osteotomy

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