Journal article
Providing a computationally derived, mechanically optimised target correction during preoperative planning can improve joint contact mechanics of hip dysplasia treated with periacetabular osteotomy
Hip international, Vol.34(3), pp.378-389
05/2024
DOI: 10.1177/11207000231212403
PMCID: PMC11073912
PMID: 38073284
Abstract
Preoperative identification of acetabular corrections that optimally improve joint stability and reduce elevated contact stresses could further reduce osteoarthritis progression in patients with hip dysplasia who are treated with periacetabular osteotomy (PAO). The purpose of this study was to investigate how providing patient-specific, mechanically optimal acetabular reorientations to the surgeon during preoperative planning affected the surgically achieved correction.
Preoperative CT scans were used to create patient-specific hip models for 6 patients scheduled for PAO. A simulated acetabular fragment was extracted from the preoperative pelvis model and computationally rotated to simulate candidate acetabular reorientations. For each candidate, discrete element analysis was used to compute contact stresses during walking, which were summed over the gait cycle and scaled by patient age to obtain chronic contact stress-time exposure. The ideal patient-specific reorientation was identified using a cost function that balances minimising chronic stress exposures and achieving surgically acceptable acetabular coverage angles. The optimal reorientation angles and associated contact mechanics were provided to the surgeon preoperatively. After PAO was performed, a model of the surgically achieved correction was created from a postoperative CT scan. Radiographic coverage and contact mechanics were compared between preoperative, optimal, and surgically achieved orientations.
While surgically achieved reorientations were not significantly different from optimal reorientations in radiographically measured lateral (
= 0.094) or anterior (
= 0.063) coverage, surgically achieved reorientations had significantly (
= 0.031) reduced total contact area compared to optimal reorientations. The difference in lateral coverage and peak chronic exposure between surgically achieved and optimal reorientations decreased with increasing surgeon experience using the models (R² = 0.758, R
= 0.630, respectively).
Providing hip surgeons with a patient-specific, computationally optimal reorientation during preoperative planning may improve contact mechanics after PAO, which may help reduce osteoarthritis progression in patients with hip dysplasia.
Details
- Title: Subtitle
- Providing a computationally derived, mechanically optimised target correction during preoperative planning can improve joint contact mechanics of hip dysplasia treated with periacetabular osteotomy
- Creators
- Holly D Aitken - University of IowaAspen Miller - University of IowaDominic Jl Rivas - Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USAMarcus Tatum - University of IowaRobert W Westermann - University of IowaMichael C Willey - Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, USAJessica E Goetz - Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA
- Resource Type
- Journal article
- Publication Details
- Hip international, Vol.34(3), pp.378-389
- DOI
- 10.1177/11207000231212403
- PMID
- 38073284
- PMCID
- PMC11073912
- NLM abbreviation
- Hip Int
- eISSN
- 1724-6067
- Grant note
- DOI: 10.13039/100001279, name: Orthopaedic Research and Education Foundation, award: Career Development Grant 17-001; DOI: 10.13039/100000057, name: National Institute of General Medical Sciences, award: R25GM058939
- Language
- English
- Electronic publication date
- 12/10/2023
- Date published
- 05/2024
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Orthopedics and Rehabilitation; Industrial and Systems Engineering; Injury Prevention Research Center; Athletic Training Program
- Record Identifier
- 9984530391502771
Metrics
5 Record Views