Is cup positioning easier in DDH patients previously treated with Bernese periacetabular osteotomy?

Ma, Yunqing; Luo, Dan; Cheng, Hui; Xiao, Kai; Chai, Wei; Li, Rui; Zhang, Hong

doi:10.1186/s13018-020-02001-0

Cited by 3 publications

(6 citation statements)

References 19 publications

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“…Previously, measurements were made of the hip's medial wall thickness (MWT), the distance from the hip's center to the pubic symphysis and ossa sedentarium planes, and the anterior, posterior, superior, and inferior acetabular sector angles (ASA) in the study group (Post group) and control group (Pre group). In addition, research was done on the variations in acetabular size and components between the two groups 16 . In order to indicate morphological parameters associated to postoperative acetabular stress, statistical analysis of morphological and biomechanical characteristics were conducted in this research utilizing numerous samples.…”

Section: Resultsmentioning

confidence: 99%

“…In our previous study, the morphological analysis of the position and coverage of the acetabular prosthesis in the two surgical groups was performed, which led to the differences between the two groups 16 . In this study, specifically targeting the patients undergoing THA after PAO, we aimed to investigate the mechanical influence of PAO by establishing detailed models of the hip joint, including the acetabulum and the hip prosthesis.…”

Section: Introductionmentioning

confidence: 99%

“…[13][14][15] In our previous study, the morphological analysis of the position and coverage of the acetabular prosthesis in the two surgical groups was performed, which led to the differences between the two groups. 16 In this study, specifically targeting the patients undergoing THA after PAO, we aimed to investigate the mechanical influence of PAO by establishing detailed models of the hip joint, including the acetabulum and the hip prosthesis. Detailed analysis of the spatial stress distribution in the acetabulum, combined with the preliminary morphological analysis, predicts the survival of the prosthesis, the clinical outcomes, and the postoperative motor function of the patient and also provides the best surgical plan for clinical diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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Mechanical influence of periacetabular osteotomy on late total hip arthroplasty

Chen

2023

Numer Methods Biomed Eng

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Periacetabular osteotomy (PAO) is an effective technique to treat symptomatic hip dysplasia. However, following PAO, some patients still experience persistent pain or development of hip arthritis, requiring total hip arthroplasty (THA). Issues such as whether patients with PAO are necessarily at increased risk of post-THA complications and revision of the prosthesis remain debatable. The purpose of this study was to evaluate the biomechanical influence of PAO on the acetabulum after THA by finite element analysis. Eight patients with developmental dysplasia of the hip (DDH) diagnosed in the Fourth Medical Center of the PLA General Hospital were enrolled in this research. Patientspecific hip joint models were reconstructed from computed tomography scans,

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mechanical influence of periacetabular osteotomy on late total hip arthroplasty

Chen

2023

Numer Methods Biomed Eng

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“…Periprosthetic osteotomy is one of the most effective treatments for acetabular dysplasia, which has long been a common problem in young people and adults. 17 PAO is a most complex surgery, not only technically, but even more regarding indications, limitations and types of corrections (not only on the acetabular side) and compromises which are frequently necessary to provide the best for each individual patient. Traditional PAO requires extensive surgeon’s experience and a C-arm machine.…”

Section: Discussionmentioning

confidence: 99%

Application of 3D-printed osteotomy guides in periacetabular osteotomy: A short-term clinical study

Guo

et al. 2022

Int J Artif Organs

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Objective: To compare the clinical efficacy between personalised 3-dimensional (3D) printed osteotomy and traditional osteotomy in periacetabular osteotomy (PAO). Methods: Twenty-two patients with acetabular dysplasia were randomly divided into a personalised 3D-printed osteotomy group and a traditional osteotomy group without 3D printing assistance. The operation time, intraoperative blood loss, X-ray frequency, quantity of postoperative drainage, postoperative transfusion rate, hip angle and Harris hip score of 6 months postoperative were studied and compared to evaluate the surgical efficacy between personalised 3D-printed osteotomy and traditional osteotomy in periacetabular osteotomy. Results: The operation time, intraoperative blood loss, X-ray frequency, postoperative 24 h drainage volume in the personalised 3D-printed osteotomy group (114.70 ± 2.21 min, 639.70 ± 5.00 mL, 11.82 ± 0.42 times, 231.20 ± 3.86 mL) was superior to the traditional group (150.40 ± 2.45 min, 850.50 ± 5.34 mL, 17.09 ± 0.39 times, 324.30 ± 4.06 mL). There was a statistically significant difference between the 3D-printed osteotomy group and the traditional osteotomy group in terms of the operation time, intraoperative blood loss, X-ray frequency and postoperative 24 h drainage volume ( p < 0.05). And there were no substantial differences in the hip angle and the 6-month postoperative Harris hip score between the two groups ( p > 0.05). Conclusion: The 3D-printed osteotomy template for PAO is a valid method and its short-term clinical effect is superior to that of traditional osteotomy.

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“…For example, bone grafting is often required due to bone loss, and subsequent postoperative cup migration has been reported [ 10 ], making THA after RAO more challenging than initial THA or THA after other osteotomies. Acetabular bone coverage is important for cup stability in THA after RAO owing to the tendency for bone defects in the anterior–posterior direction [ 11 ]. Previous studies have investigated acetabular defects in DDH by measuring the anteroposterior angle using computed tomography (CT) [ 12 ]; however, to the best of our knowledge, no study to date has investigated the acetabular defects in THA after osteotomy in the anteroposterior direction.…”

Section: Introductionmentioning

confidence: 99%

Total hip arthroplasty after rotational acetabular osteotomy for developmental dysplasia of the hip: a retrospective observational study

Iwata

Shimamura

Senda

et al. 2022

BMC Musculoskelet Disord

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Background Total hip arthroplasty after osteotomy is more technically challenging than primary total hip arthroplasty, especially concerning cup placement. This is attributed to bone morphological abnormalities caused by acetabular bone loss and osteophyte formation. This study aimed to investigate the clinical and radiological outcomes of total hip arthroplasty after rotational acetabular osteotomy compared with those of primary total hip arthroplasty, focusing mainly on acetabular deformity and cup position. Methods The study included 22 hips that had undergone rotational acetabular osteotomy and 22 hips in an age- and sex-matched control group of patients who underwent total hip arthroplasties between 2005 and 2020. We analyzed cup abduction and anteversion; lateral, anterior, and posterior cup center–edge angle; hip joint center position; femoral anteversion angle; and presence of acetabular defect using postoperative radiography and computed tomography. Operative results and clinical evaluations were also analyzed. Results The clinical evaluation showed that the postoperative flexion range of motion was lower in total hip arthroplasty after rotational acetabular osteotomy than in primary total hip arthroplasty, although no significant difference was noted in the postoperative total Japanese Orthopedic Association hip score. The operative time was significantly longer in the rotational acetabular osteotomy group than in the control group, but there was no significant difference in blood loss. The lateral cup center–edge angle was significantly higher and the posterior cup center–edge angle was significantly lower in the total hip arthroplasty after rotational acetabular osteotomy, suggesting a posterior bone defect existed in the acetabulum. In total hip arthroplasty after rotational acetabular osteotomy, the hip joint center was located significantly superior and lateral to the primary total hip arthroplasty. Conclusions In total hip arthroplasty after rotational acetabular osteotomy, the cup tended to be placed in the superior and lateral positions, where there was more bone volume. The deformity of the acetabulum and the high hip center should be considered for treatment success because they may cause cup instability, limited range of motion, and impingement.

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Is cup positioning easier in DDH patients previously treated with Bernese periacetabular osteotomy?

Cited by 3 publications

References 19 publications

Mechanical influence of periacetabular osteotomy on late total hip arthroplasty

Mechanical influence of periacetabular osteotomy on late total hip arthroplasty

Application of 3D-printed osteotomy guides in periacetabular osteotomy: A short-term clinical study

Total hip arthroplasty after rotational acetabular osteotomy for developmental dysplasia of the hip: a retrospective observational study

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