Biomechanical study of load transfer of the pubic ramus due to pelvic inclination after hip joint surgery using a three-dimensional finite element model

Kaku, Nobuhiro; Tsumura, Hiroshi; Taira, Hirofumi; Sawatari, Tomoyuki; Torisu, Takehiko

doi:10.1007/s00776-004-0772-9

Cited by 42 publications

(31 citation statements)

References 14 publications

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“…They inferred that the fractures derive from disruption of continuity at the site of pubic osteotomy, which alters load transfer from the lower extremities, based on past reports [17,18]. Our model demonstrates that with discontinuity at the site of osteotomy of the superior pubic rami, the stress field is concentrated from the inferior pubic rami to ischial bone, especially on the proximal inferior pubic rami.…”

Section: Discussionsupporting

confidence: 50%

Effects of Curved Periacetabular Osteotomy on the Stress Fields of the Pubic Rami and Ischium: A Finite Element Model Analysis

Imai¹,

Dohmae²,

Suda³

et al. 2013

OJO

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Background: Postoperative pubic or ischial stress fracture may be a complication after curved periacetabular osteotomy (CPO). The discontinuity of the superior pubic rami is a risk factor for this complication. We investigated the stress field differences in standing and sitting positions after CPO. Methods: We used finite element analysis to assess the effects of inferior pubic rami and ischial fractures with or without discontinuity of superior pubic rami. We used the "union model", obtained from a bony union at the osteotomy site of the superior pubic rami from 38-year-old woman who had undergone CPO for left hip dysplasia. We deleted the bony union region and created a discontinuity in the superior pubic rami equal to the non-union, creating the "discontinuity model". We compared the stress field and stress value in the simulated standing and half weight-bearing positions on the operative side, one-legged standing position on the non-operative side, and the sitting position. Findings: In 4 cases, the inferior rami experienced the highest stress. Stress values in the discontinuity model were higher than those in the union model: 1.7 times in the case of one-legged standing on the operative side, 2.4 times in the case of half weight-bearing on the operative side, 3.8 times in the case of one-legged standing on the non-operative side, and 2.0 times in the sitting position, respectively. Interpretation: We recommend patients delay weight bearing on the operative side, avoid the sitting position as long as possible, and sit down slowly to prevent inferior pubic rami and ischial fractures after CPO.

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Section: Discussionsupporting

confidence: 50%

Effects of Curved Periacetabular Osteotomy on the Stress Fields of the Pubic Rami and Ischium: A Finite Element Model Analysis

Imai¹,

Dohmae²,

Suda³

et al. 2013

OJO

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“…It plays an important role in the musculoskeletal system bearing our entire body weight and transferring it to the lower extremities. Load transfer across the hip joint has been widely studied in the literature [13,25,30]. Understanding the load transfer mechanisms is of critical importance to identify pathologies origin and thus decide on an appropriate treatment.…”

Section: Introductionmentioning

confidence: 99%

Normal and osteoarthritic hip joint mechanical behaviour: a comparison study

Pustoc'h

Chèze

2009

Med Biol Eng Comput

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The assessment of contact areas within the hip joint during activities of daily living is of critical importance to understand why degeneration mechanisms are sometimes initiated. A generic finite element model is developed and constrained with experimental personalized conditions to locate contact areas and determine pressure distribution, both during walking and stair climbing. Bony structures are positioned in relation to each other by using experimental kinematical data. Implemented loading conditions are computed from an inverse dynamic approach coupled with an optimization method. The mechanical behaviour of a healthy hip joint is first simulated. This model is then used as a reference for the evaluation of a pathological mechanical behaviour. Thus, experimental data are collected for a patient presenting a coxarthrosis. The comparison of the pathological and normal behaviours emphasizes that the contact area swept within the osteoarthritic hip joint is limited both during walking and stair climbing.

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“…However, because the superior ramus is osteotomized during PAO, load transmission can occur only through the inferior pubic ramus and the ischium. This increased load could lead to additional strain, which then could initiate a fracture of the inferior ramus or the ischium [9].…”

Section: Discussionmentioning

confidence: 99%

Extraarticular Fractures after Periacetabular Osteotomy

Espinosa

Strassberg

Belzile

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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Extraarticular fractures of the pelvic ring after periacetabular osteotomy could impair stability of the acetabular fragment and cause poor clinical and radiographic outcomes. We evaluated 17 patients (17 hips) with fractures of either the ipsilateral os pubis (n = 12) or os ischium (n = 5) during the postoperative period after periacetabular osteotomy. Ischial fractures seemed more debilitating with two of five resulting in painful nonunions for which additional surgery was performed. In contrast, only one patient with pubic fracture had additional surgery. Ischial fractures took almost twice as long to achieve resolution of symptoms compared with pubic fractures, and when left untreated, asymptomatic nonunions developed in three of five.

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Biomechanical study of load transfer of the pubic ramus due to pelvic inclination after hip joint surgery using a three-dimensional finite element model

Cited by 42 publications

References 14 publications

Effects of Curved Periacetabular Osteotomy on the Stress Fields of the Pubic Rami and Ischium: A Finite Element Model Analysis

Effects of Curved Periacetabular Osteotomy on the Stress Fields of the Pubic Rami and Ischium: A Finite Element Model Analysis

Normal and osteoarthritic hip joint mechanical behaviour: a comparison study

Extraarticular Fractures after Periacetabular Osteotomy

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