Computer-Assisted Rotational Acetabular Osteotomy for Patients with Acetabular Dysplasia

Aims Rotational acetabular osteotomy (RAO) is an effective joint-preserving surgical treatment for acetabular dysplasia. The purpose of this study was to investigate changes in muscle strength, gait speed, and clinical outcome in the operated hip after RAO over a one-year period using a standard protocol for rehabilitation. Patients and Methods A total of 57 patients underwent RAO for acetabular dysplasia. Changes in muscle strength of the operated hip, 10 m gait speed, Japanese Orthopaedic Association (JOA) hip score, and factors correlated with hip muscle strength after RAO were retrospectively analyzed. Results Three months postoperatively, the strength of the operated hip in flexion and abduction and gait speed had decreased from their preoperative levels. After six months, the strength of flexion and abduction had recovered to their preoperative level, as had gait speed. At one-year follow-up, significant improvements were seen in the strength of hip abduction and gait speed, but muscle strength in hip flexion remained at the preoperative level. The mean JOA score for hip function was 91.4 (51 to 100)) at one-year follow-up. Body mass index (BMI) showed a negative correlation with both strength of hip flexion (r = -0.4203) and abduction (r = -0.4589) one year after RAO. Although weak negative correlations were detected between strength of hip flexion one year after surgery and age (r = -0.2755) and centre-edge (CE) angle (r = -0.2989), no correlation was found between the strength of abduction and age and radiological evaluations of CE angle and acetabular roof obliquity (ARO). Conclusion Hip muscle strength and gait speed had recovered to their preoperative levels six months after RAO. The clinical outcome at one year was excellent, although the strength of hip flexion did not improve to the same degree as that of hip abduction and gait speed. A higher BMI may result in poorer recovery of hip muscle strength after RAO. Radiologically, acetabular coverage did not affect the recovery of hip muscle strength at one year’s follow-up. A more intensive rehabilitation programme may improve this. Cite this article: Bone Joint J 2019;101-B:1459–1463.

Download Full-text

Computer-assisted anteverting eccentric rotational acetabular osteotomy for recurrent posterior dislocation associated with acetabular retroversion: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-018-1949-8 ◽

2019 ◽

Vol 13 (1) ◽

Author(s):

Hiroshi Imai ◽

Jun Takeba ◽

Akira Maruishi ◽

Joji Miyawaki ◽

Tomomi Kamada ◽

...

Keyword(s):

Case Report ◽

Acetabular Retroversion ◽

Posterior Dislocation ◽

Rotational Acetabular Osteotomy ◽

Computer Assisted ◽

Eccentric Rotational Acetabular Osteotomy

Download Full-text

Systematic review of pre-operative planning modalities for correction of acetabular dysplasia

Journal of Hip Preservation Surgery ◽

10.1093/jhps/hnz057 ◽

2019 ◽

Vol 6 (4) ◽

pp. 316-325 ◽

Cited By ~ 1

Author(s):

Alexander J Acuña ◽

Linsen T Samuel ◽

Bilal Mahmood ◽

Atul F Kamath

Keyword(s):

Acetabular Dysplasia ◽

Single Case ◽

Case Series ◽

Developmental Dysplasia ◽

Small Sample ◽

Guidance System ◽

Computer Assisted ◽

Acetabular Fragment ◽

Operative Planning ◽

Ebsco Host

Abstract Acetabular dysplasia, related to developmental dysplasia of the hip, causes the abnormal distribution of hip joint forces. Surgical correction of acetabular dysplasia involves repositioning the acetabulum to achieve improved coverage of the femoral head. However, ideal placement of the acetabular fragment is challenging, and has led to an increased interest in pre-operative planning modalities. In this study, we used the PubMed and EBSCO host databases to systematically review all the modalities for pre-operative planning of acetabular dysplasia proposed in the current literature. We included all case-series, English, full-text manuscripts pertaining to pre-operative planning for congenital acetabular dysplasia. Exclusion criteria included: total hip arthroplasty (THA) planning, patient population mean age >35, and double/single case studies. A total of 12 manuscripts met our criteria for a total of 186 hips. Pre-operative planning modalities described were: Amira (Thermo Fischer Scientific; Waltham, MA, USA) 12.9%, OrthoMap (Stryker Orthopaedics; Mahwah, NJ, USA) 36.5%, Amira + Biomechanical Guidance System 5.9%, Mills et al. method 16.1%, Klaue et al. method 16.1%, Armand et al. method 6.5%, Tsumura et al. method 3.8% and Morrita et al. method 2.2%. As a whole, there was a notable lack of prospective studies demonstrating these modalities’ efficacy, with small sample sizes and lack of commercial availability diminishing their applicability. Future studies are needed to comprehensively compare computer-assisted planning with traditional radiographic assessment of ideal osteotomy orientation.

Download Full-text