ArticleClinical biomechanics (Bristol, Avon)2023
Radiographically successful periacetabular osteotomy does not achieve optimal contact mechanics in dysplastic hips.
Article in Clinical biomechanics (Bristol, Avon), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Radiographic measures of hip dysplasia correlate only moderately with computationally derived contact mechanics.Journal of hip preservation surgery · 2026Article
- Dysplastic Hips in Young Adults Demonstrate Different Relationships Between Acetabular Coverage, Joint Congruity, and Contact Mechanics Than Asymptomatic Hips.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2025Article
- Three-dimensional assessment of subchondral arc and hip joint coverage angles in the asymptomatic young adult hip.Clinical anatomy (New York, N.Y.) · 2025Article
- Radiographically Apparent Acetabular Sourcil Landmarks Are Created by Comparable Regions of the Pelvis With Extraarticular Bone Variably Confounding Estimates of Joint Coverage.Clinical orthopaedics and related research · 2025Article
- Persistently elevated joint contact stress after periacetabular osteotomy is associated with joint failure at minimum 10-year follow-up.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2024Article
- Providing a computationally derived, mechanically optimised target correction during preoperative planning can improve joint contact mechanics of hip dysplasia treated with periacetabular osteotomy.Hip international : the journal of clinical and experimental research on hip pathology and therapy · 2024Article
- Arthritis Foundation/HSS Workshop on Hip Osteoarthritis, Part 2: Detecting Hips at Risk: Early Biomechanical and Structural Mechanisms.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2023Review
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Authors and funding
7 authors.
Funding
Abstract
backgroundOptimal correction of hip dysplasia via periacetabular osteotomy may reduce osteoarthritis development by reducing damaging contact stress. The objective of this study was to computationally determine if patient-specific acetabular corrections that optimize contact mechanics can improve upon contact mechanics resulting from clinically successful, surgically achieved corrections.
methodsPreoperative and postoperative hip models were retrospectively created from CT scans of 20 dysplasia patients treated with periacetabular osteotomy. A digitally extracted acetabular fragment was computationally rotated in 2-degree increments around anteroposterior and oblique axes to simulate candidate acetabular reorientations. From discrete element analysis of each patient's set of candidate reorientation models, a mechanically optimal reorientation that minimized chronic contact stress exposure and a clinically optimal reorientation that balanced improving mechanics with surgically acceptable acetabular coverage angles was selected. Radiographic coverage, contact area, peak/mean contact stress, and peak/mean chronic exposure were compared between mechanically optimal, clinically optimal, and surgically achieved orientations.
findingsCompared to actual surgical corrections, computationally derived mechanically/clinically optimal reorientations had a median[IQR] 13[4-16]/8[3-12] degrees and 16[6-26]/10[3-16] degrees more lateral and anterior coverage, respectively. Mechanically/clinically optimal reorientations had 212[143-353]/217[111-280] mm
interpretationComputationally selected orientations achieved a greater mechanical improvement than surgically achieved corrections; however, many predicted corrections would be considered acetabular over-coverage. Identifying patient-specific corrections that balance optimizing mechanics with clinical constraints will be necessary to reduce the risk of osteoarthritis progression after periacetabular osteotomy.
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