A computer simulation of rotational acetabular osteotomy for dysplastic hip joint: does the optimal transposition of the acetabular fragment exist?

Tsumura, Hiroshi; Kaku, Nobuhiro; Ikeda, Shigeo; Torisu, Takehiko

doi:10.1007/s00776-004-0866-4

Cited by 41 publications

(44 citation statements)

References 19 publications

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“…Although we suspected anterior uncovering of the acetabulum attributable to posterior pelvic tilt might be associated with SIF, the pelvic tilt was similar in the two groups. Previous biomechanical studies showed the joint contact pressure of dysplastic hips is concentrated on the lateral edge of the acetabulum [2,12,19]. Increased stress on the acetabular rim also reportedly is associated with acetabular lesions such as labral tears and ganglion cysts [9,10].…”

Section: Discussionmentioning

confidence: 99%

Subchondral Insufficiency Fracture of the Femoral Head may be Associated with Hip Dysplasia: A Pilot Study

Ishihara

Miyanishi

Ihara

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Subchondral insufficiency fracture of the femoral head occurs mainly in elderly patients with osteoporosis. Spontaneous resolution is observed after nonoperative treatment in some patients whereas other show progressive joint destruction requiring THA. Several studies report the occurrence of subchondral insufficiency fracture of the femoral head in dysplastic hips. Questions/purposes We asked whether the extent of hip dysplasia or osteoporosis was greater in patients with subchondral insufficiency fracture of the femoral head than in normal control subjects. Patients and Methods We compared the clinical and imaging findings of 13 patients with subchondral insufficiency fractures of the femoral head and 12 patients scheduled for TKA with asymptomatic hips. Age, gender, and body mass index were comparable in the two groups. Results Higher mean Sharp angles, lower acetabular head indices, lower center-edge angles, and higher acetabular roof angles in patients with subchondral insufficiency fracture of the femoral head than in those with asymptomatic hips suggested a greater degree of hip dysplasia.Bone mineral density and serum levels of Type I collagen cross-linked N-telopeptide and bone alkaline phosphatase were similar in the two groups. Conclusions We speculate an excessive amount of stress on the acetabular edge from dysplasia may be associated with the occurrence of subchondral insufficiency fracture of the femoral head.

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Section: Discussionmentioning

confidence: 99%

Subchondral Insufficiency Fracture of the Femoral Head may be Associated with Hip Dysplasia: A Pilot Study

Ishihara

Miyanishi

Ihara

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…The position for optimal correction is specific for each patient, and fairly narrowly defined [54]. Tsumura et al studied three-dimensional joint pressure redistribution in dysplastic hips, and noted that the lowest peak pressures were achieved by transposing the acetabular fragment to within 5°of the optimal transposition point [55]. Individualized preoperative planning with understanding of a patient's specific deformity is crucial to proper acetabular reorientation [21,40,46,56].…”

Section: Introductionmentioning

confidence: 99%

Pelvic Positioning Creates Error in CT Acetabular Measurements

Bosse¹,

Lee

Henderson

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background CT allows for accurate measurement of acetabular orientation and shape, but malpositioning of the pelvis may lead to measurement variance. Purpose We therefore sought to determine: (1) whether acetabular anteversion measurements using the femoral head centers differed from those using the posterior ischia, and (2) the extent to which changing obliquity, rotation, and tilt of a pelvis in a CT scanner affected the measurement of acetabular variables. Methods A radiopaque human pelvis model with articulated hips was suspended from a plastic sheet as part of an adjustable frame. Changes in the transverse and sagittal planes created rotation and tilt, while rotating the frame in the coronal plane created obliquity. CT scans were obtained, varying the combinations of obliquity, rotation, and tilt by intervals of 5°, up to 20°. Acetabular anteversion (AA), anterior acetabular sector angle (AASA), posterior acetabular sector angle (PASA), and horizontal acetabular sector angle (HASA) were measured. Results The two methods for measuring AA yielded values differing by 1°to 4°but correlated (r = 0.981) across the spectrum of pelvis positioning. Pelvic obliquity and tilt were linearly associated with changes in the measurements. For each 1°-increase in pelvic obliquity, AA changed À0.4°, and AASA, PASA, and HASA changed 1.93°, 0.99°, and 2.80°, respectively. For each 1°-increase in pelvic tilt, AA changed 0.8°, and AASA, PASA, and HASA changed À1.07°, 0.52°, and À0.51°, respectively. Rotation had no affect on the variables. Conclusions Small changes in pelvic obliquity and tilt were associated with variances in acetabular measurements. The measured changes were directly proportional to the changes in obliquity and tilt, and were additive. Pelvic rotation created no changes in measurement. Clinical Relevance Incorrect interpretation of acetabular anteversion and coverage may lead to unsatisfactory acetabular fragment positioning during reorientational surgery. Although intraoperative positioning of an acetabular fragment may not be as precise as the tools for preoperative planning, it is important for a surgeon to have the most precise data available for planning a procedure, and know where error can occur in collecting the data.Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

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“…5 Various types of periacetabular osteotomy are used in patients who are too young for total hip replacement. [13][14][15][16][17][18][19] We perform a curved periacetabular osteotomy, 16 which is a modification of the Bernese periacetabular osteotomy developed by Ganz et al 13 Although many reports have shown that periacetabular osteotomy can reduce contact stress in the hip joint, [20][21][22][23][24] none have clarified whether it can also reduce instability during walking in daily life. After our previous study 7 we hypothesised that dynamic instability of the hip joint would be reduced if the cover of the femoral head was improved by periacetabular osteotomy.…”

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confidence: 99%

Periacetabular osteotomy reduces the dynamic instability of dysplastic hips

Maeyama

Naito

Moriyama

et al. 2009

The Journal of Bone and Joint Surgery. British volume

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We compared the dynamic instability of 25 dysplastic hips in 25 patients using triaxial accelerometry before and one year after periacetabular osteotomy. We also evaluated the hips clinically using the Harris hip score and assessed acetabular orientation by radiography before surgery and after one year. The mean overall magnitude of acceleration was significantly reduced from 2.30 m/s 2 (SD 0.57) before operation to 1.55 m/s 2 (SD 0.31) afterwards. The mean Harris hip score improved from 78.08 (47 to 96) to 95.36 points (88 to 100). The radiographic parameters all showed significant improvements. This study suggests that periacetabular osteotomy provides pain relief, improves acetabular cover and reduces the dynamic instability in patients with dysplastic hips.

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A computer simulation of rotational acetabular osteotomy for dysplastic hip joint: does the optimal transposition of the acetabular fragment exist?

Cited by 41 publications

References 19 publications

Subchondral Insufficiency Fracture of the Femoral Head may be Associated with Hip Dysplasia: A Pilot Study

Subchondral Insufficiency Fracture of the Femoral Head may be Associated with Hip Dysplasia: A Pilot Study

Pelvic Positioning Creates Error in CT Acetabular Measurements

Periacetabular osteotomy reduces the dynamic instability of dysplastic hips

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