Biomechanical study on the efficacy of the periacetabular osteotomy using Patient-specific finite element analysis

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• 作者：Kyung-Jin Lee (1)
  Sung-Jae Park (2)
  Sung-Jae Lee (2)
  Masatoshi Naito (3)
  Soon-Yong Kwon (1)
  
  1. Department of Orthopaedic Surgery ; St. Mary鈥檚 Hospital ; Catholic University ; 10 ; 63-ro ; Yeongdeungpo-gu ; Seoul ; 150-713 ; South Korea
  2. Department of Biomedical Engineering ; Inje University ; 197 ; Inje-ro ; Gimhae-si ; Gyeongsangnam-do ; 621-749 ; South Korea
  3. Department of Orthopaedic Surgery ; Fukuoka University School of Medicine ; Fukuoka ; 814-0180 ; Japan
  
• 关键词：Periacetabular Ostoetomy (PAO) ; Developmental Dysplasia of the Hip (DDH) ; Biomechanical study ; Patient ; specific ; Finite Element Analysis (FEA)
• 刊名：International Journal of Precision Engineering and Manufacturing
• 出版年：2015
• 出版时间：April 2015
• 年：2015
• 卷：16
• 期：4
• 页码：823-829
• 全文大小：699 KB
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• 刊物类别：Engineering
• 刊物主题：Industrial and Production Engineering
  Materials Science
  
• 出版者：Korean Society for Precision Engineering, in co-publication with Springer Verlag GmbH
• ISSN：2005-4602

文摘

Periacetabular osteotomy (PAO) is a joint-preserving surgical procedure and it has been introduced as a surgical alternative to the total hip arthroplasty (THA) for young person. However, its clinical and biomechanical efficacies remain unknown. In this study, we constructed patient-specific finite element (FE) models of the hip joint before and after surgery to evaluate the efficacies in more quantitative fashion. 3-D FE models were constructed based on patient's computed tomography (CT) images. Post-operative geometrical changes in joint contact areas, center-edge (CE) angle and distance between the symphysis pubis and the femoral head (DBSPFH) were assessed in three dimensions. In addition, changes in peak contact pressures and peak von Mises stress (PVMS) at the hip joint were predicted. After PAO, CE angle was increased by 126.2% and DBSPFH was decreased by 3.7%. The contact area was increased by 32% while peak contact pressure was decreased by 53.8%. More even distribution of stresses at the femur were observed. Our results suggested that for this given patient PAO was an effective reconstructive surgical choice in terms of reconstructing joint congruency. Therefore, PAO can be considered a good alternative to THA especially for young patients who need to be treated with joint-preserving techniques.