Factors Associated With Abnormal Joint Contact Pressure After Periacetabular Osteotomy: A Finite-Element Analysis
Factors Associated With Abnormal Joint Contact Pressure After Periacetabular Osteotomy: A Finite-Element Analysis
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DOI：
10.1016/j.arth.2022.04.045
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发表时间：
2022-09-23
影响因子：
3.5
通讯作者：
Nakashima, Yasuharu
中科院分区：
文献类型：
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作者：
Kitamura, Kenji;Fujii, Masanori;Nakashima, Yasuharu
背景资料：确定与髋臼周围截骨术（PAO）后髋关节接触力学不良相关的因素可能有助于外科医生优化个体患者的髋臼矫正。我们进行了个体特定的有限元分析，以确定PAO后异常接触压力（CP）的术前形态和手术矫正因素。方法：我们在PAO之前和之后进行了有限元分析，参考个体特定的站立骨盆位置根据51个发育不良髋关节的计算机断层扫描图像创建的三维髋关节模型。采用非线性接触分析方法计算单腿站立时髋臼软骨的关节接触压（98.0%），并且由此产生的最大CP在正常范围内（54.3度，术后站立骨盆位前CEA 27.0度预测PAO后CP异常。PAO使64.7%的患者的关节CP恢复正常，但不太可能使非球面股骨头患者的关节CP恢复正常。成功的手术治疗取决于获得足够的前部覆盖和避免过度的侧向矫正，同时考虑到在负重位置的生理骨盆倾斜。(c)2022爱思唯尔公司All rights reserved.
Background: Identifying factors associated with poor hip contact mechanics after periacetabular osteotomy (PAO) may help surgeons optimize acetabular corrections in individual patients. We per-formed individual-specific finite-element analyses to identify preoperative morphological and surgical correction factors for abnormal contact pressure (CP) after PAO.Methods: We performed finite-element analyses before and after PAO with reference to the standing pelvic position on individual-specific 3-dimensional hip models created from computed tomography images of 51 dysplastic hips. Nonlinear contact analyses were performed to calculate the joint CP of the acetabular cartilage during a single-leg stance.Results: The maximum CP decreased in 50 hips (98.0%) after PAO compared to preoperative values, and the resulting maximum CP was within the normal range (54.3 degrees, a postoperative anterior CEA 27.0 degrees in the standing pelvic position predicted abnormal CP after PAO.Conclusion: PAO normalized joint CP in 64.7% of the patients but was less likely to normalize joint CP in patients with aspheric femoral heads. Successful surgical treatment depends on obtaining adequate anterior coverage and avoiding excessive lateral correction, while considering the physiological pelvic tilt in a weight-bearing position.(c) 2022 Elsevier Inc. All rights reserved.