Evaluation of the short-term curative effect of closed reduction in the treatment of developmental dysplasia of the hip based on three-dimensional magnetic resonance imaging finite element analysis.

backgroundBased on the Digital Imaging and Communications in Medicine (DICOM) data of three-dimensional magnetic resonance imaging (3D-MRI), finite element models of the hip joints of children with developmental dysplasia of the hip were established. The primary objectives included simulation and analysis of the finite element model pre- and post-closed reduction under different stances and loads, and evaluation of the size and distribution of von Mises stress in the acetabulum and femoral head pre- and post-operation and the short-term effects.

methodsAcetabular index measurements of both the unaffected and affected sides were conducted, alongside International Hip Dysplasia Institute (IHDI) classification of the affected hip. Establishing the finite element model of both the affected and unaffected hips was based on the 3D-T1WI sequence DICOM data, using Mimics, 3-matic, and Ansys software, before and after closed reduction surgery. The size and distribution data of von Mises stress on the affected side of the acetabulum and femoral head were collected pre- and post-operation.

resultsThe study indicated that the increasing acetabular index of the affected hip was directly proportional to the increasing severity based on IHDI classification (P < 0.05). Preoperative IHDI classification significantly correlated with the von Mises stress (r = 0.560-0.569, 0.562-0.564, P < 0.05). Under different stances and load conditions, the von Mises stress on the affected side post-operation was lower than that noted pre-operation (P < 0.01), while that on the acetabulum increased proportionally to the load. Although the magnitude and distribution of von Mises stress on the affected side of the acetabulum were similar to those on the healthy side post-operation, there were statistical differences between the two (P < 0.01). The von Mises stress of the lateral column of the femoral head post-operation was significantly lower than that noted pre-operation (P < 0.01). While the high-stress points of the lateral column disappeared post-operation, the von Mises stress was evenly distributed in the femoral head.

conclusionsThe 3D-MRI finite element could provide the von Mises stress value and distribution characteristics of the acetabulum and femoral head pre- and post-operation. Closed reduction can, therefore, improve the size and distribution of von Mises stress on the affected acetabulum and femoral head.