Int J Comput Assist Radiol Surg - Articular surface remodeling of the hip after periacetabular osteotomy.

Tópicos

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Resumo

RPOSE: Periacetabular osteotomies are a family of surgical procedures used to treat hip dysplasia. In a periacetabular osteotomy, the operating surgeon aims to increase acetabular coverage of the femoral head. The surgical correction has mechanical goals of increasing the stability of the joint and to improving the pressure distribution across the acetabulum. Although it is known that bone will remodel under changing load at the microstructural level, it is unclear whether there is any gross remodeling of the acetabulum or the femoral head in response to the change in loading following a periacetabular osteotomy. This observational study aims to quantify the shape of operative and contralateral hip joint surfaces pre and postoperatively to determine whether there are gross morphological changes in the shape of any of the bony articular surfaces of the joint.METHODS: Preoperative and postoperative computed tomography (CT) scans were segmented as triangulated meshes. The bony articular surfaces of these meshes were then isolated. The vertices of these surfaces were fit to spheres and to general ellipsoids and, in the case of the acetabulum, examined in anatomical coordinate frames to look for changes between pre and postoperative segmentations.RESULTS: Spherical fit results were consistent preoperatively and postoperatively, with small changes in the radii of the spheres of best fit for both operative and nonoperative hips. Ellipsoid fitting showed variations between preoperative and postoperative scans in both eccentricity and orientation.CONCLUSIONS: Because there is no clear evidence of gross articular surface remodeling, periacetabular osteotomy for an adult should be planned with the expectation that the patient's existing articular structure will be preserved.

Resumo Limpo

rpose periacetabular osteotomi famili surgic procedur use treat hip dysplasia periacetabular osteotomi oper surgeon aim increas acetabular coverag femor head surgic correct mechan goal increas stabil joint improv pressur distribut across acetabulum although known bone will remodel chang load microstructur level unclear whether gross remodel acetabulum femor head respons chang load follow periacetabular osteotomi observ studi aim quantifi shape oper contralater hip joint surfac pre postop determin whether gross morpholog chang shape boni articular surfac jointmethod preoper postop comput tomographi ct scan segment triangul mesh boni articular surfac mesh isol vertic surfac fit sphere general ellipsoid case acetabulum examin anatom coordin frame look chang pre postop segmentationsresult spheric fit result consist preoper postop small chang radii sphere best fit oper nonop hip ellipsoid fit show variat preoper postop scan eccentr orientationconclus clear evid gross articular surfac remodel periacetabular osteotomi adult plan expect patient exist articular structur will preserv

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