Three-dimensional acetabular orientation during periacetabular osteotomy: A videoanalysis of acetabular rim position using an external fixator as navigation tool during reorientation procedure

URN to cite this document:

urn:nbn:de:bvb:355-epub-448258 Copy

DOI to cite this document:

10.5283/epub.44825 Copy

Schwarz, Timo J. ; Maderbacher, Günther ; Leiss, Franziska ; Grifka, Joachim

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Date of publication of this fulltext: 09 Feb 2021 10:48

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Details

Item type:	Article
Open Access Type:	DEAL (Springer)
Journal or Publication Title:	Archives of Orthopaedic and Trauma Surgery
Publisher:	Springer
Place of Publication:	NEW YORK
Date:	2020
Institutions:	Medicine > Lehrstuhl für Orthopädie
Identification Number:	Value Type 10.1007/s00402-020-03632-y DOI
Keywords:	FOLLOW-UP; TRIPLE OSTEOTOMY; CUP MEASUREMENT; DYSPLASIA; SURVIVORSHIP; HIPS; THA; Periacetabular osteotomy; Retroversion; Dysplasia; Hip surgery; Impingement; Navigation
Dewey Decimal Classification:	600 Technology > 610 Medical sciences Medicine
Status:	Published
Refereed:	Yes, this version has been refereed
Created at the University of Regensburg:	Yes
Item ID:	44825

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Abstract

Introduction Bernese periacetabular osteotomy is an effective procedure for treating acetabular dysplasia. However, limited visual control of the acetabular position during surgery may result in under- or overcorrection with residual dysplasia or femoroacetabular impingement. Thus, we wanted to find a simple method to control the effect of correction in the sagittal and coronal plane. Method The ...

Abstract

Introduction Bernese periacetabular osteotomy is an effective procedure for treating acetabular dysplasia. However, limited visual control of the acetabular position during surgery may result in under- or overcorrection with residual dysplasia or femoroacetabular impingement. Thus, we wanted to find a simple method to control the effect of correction in the sagittal and coronal plane. Method The acetabular coordinates are shown by two perpendicular tubes of an external fixator mounted onto a third tube that is fixed to the acetabular fragment with two Schanz screws. This method enables the isolated acetabular reorientation in the coronal, sagittal, and transverse plane. In a sawbone pelvis model, the acetabular rim is marked with a copper wire and a silicon adherent. To show the radiographic effect on acetabular parameters and the rim position, we visualized correction in the coronal and sagittal plane under fluoroscopic control. Results Lateral rotation of the acetabular fragment had the highest impact on radiographic lateral coverage of the femoral head. But also ventral coverage increased during isolated lateral rotation. Anterior rotation showed almost no effect on lateral coverage and just a little effect on ventral coverage but caused severe total acetabular retroversion. Conclusion Three-dimensional control of the acetabular orientation during periacetabular osteotomy is important to avoid over- and under-correction. Isolated lateral rotation of the acetabular fragment should be the predominant direction of correction during periacetabular osteotomy. Ambitious anterior correction may be the main source for severe acetabular retroversion following periacetabular osteotomy.

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Metadata last modified: 16 Jan 2025 15:00

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