Three-dimensional mechanical evaluation of joint contact pressure in 12 periacetabular osteotomy patients with 10-year follow-up.
BACKGROUND AND PURPOSE: Because of the varying structure of dysplastic hips, the optimal realignment of the joint during periacetabular osteotomy (PAO) may differ between patients. Three-dimensional (3D) mechanical and radiological analysis possibly accounts better for patient-specific morphology, a...
| Publicado en: | Acta Orthopaedica Vol. 80; no. 2; pp. 155 - 162 |
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| Autores principales: | , , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Medical Journals Sweden AB
Apr2009
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105519431&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105519431 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17453674 1BVL jtl: Acta Orthopaedica issn: 17453674 maglogo: N pubinfo: dt: Apr2009 vid: 80 iid: 2 pid: 59195 pub: Medical Journals Sweden AB artinfo: ui: 105519431 2010268711 10.3109/17453670902947390 NLM19404795 105519431 ppf: 155 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Three-dimensional mechanical evaluation of joint contact pressure in 12 periacetabular osteotomy patients with 10-year follow-up. aug: au: Armiger RS Armand M Tallroth K Lepistö J Mears SC affil: Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA. sug: subj: Acetabulum Surgery Osteotomy Methods Adult Biomechanics Clinical Assessment Tools Descriptive Statistics Female Funding Source Hip Dislocation, Congenital Surgery Hip Anatomy and Histology Mechanics Middle Age Record Review Retrospective Design Stress, Mechanical Tomography, X-Ray Computed Human Adult: 19-44 years Middle Aged: 45-64 years Female ab: BACKGROUND AND PURPOSE: Because of the varying structure of dysplastic hips, the optimal realignment of the joint during periacetabular osteotomy (PAO) may differ between patients. Three-dimensional (3D) mechanical and radiological analysis possibly accounts better for patient-specific morphology, and may improve and automate optimal joint realignment. PATIENTS AND METHODS: We evaluated the 10-year outcomes of 12 patients following PAO. We compared 3D mechanical analysis results to both radiological and clinical measurements. A 3D discrete-element analysis algorithm was used to calculate the pre- and postoperative contact pressure profile within the hip. Radiological angles describing the coverage of the joint were measured using a computerized approach at actual and theoretical orientations of the acetabular cup. Quantitative results were compared using postoperative clinical evaluation scores (Harris score), and patient-completed outcome surveys (q-score) done at 2 and 10 years. RESULTS: The 3D mechanical analysis indicated that peak joint contact pressure was reduced by an average factor of 1.7 subsequent to PAO. Lateral coverage of the femoral head increased in all patients; however, it did not proportionally reduce the maximum contact pressure and, in 1 case, the pressure increased. This patient had the lowest 10-year q-score (70 out of 100) of the cohort. Another hip was converted to hip arthroplasty after 3 years because of increasing osteoarthritis. INTERPRETATION: The 3D analysis showed that a reduction in contact pressure was theoretically possible for all patients in this cohort, but this could not be achieved in every case during surgery. While intraoperative factors may affect the actual surgical outcome, the results show that 3D contact pressure analysis is consistent with traditional PAO planning techniques (more so than 2D analysis) and may be a valuable addition to preoperative planning and intraoperative assessment of joint realignment. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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