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26 December 2016 : Clinical Research  

Theoretical Implications of Periacetabular Osteotomy in Various Dysplastic Acetabular Cartilage Defects as Determined by Finite Element Analysis

Meng Xu1ABCDEF, Wenrui Qu1ABCDEF, Yanbing Wang1BCDE, Lei Zhong1BCDE, Zhe Zhu1BCD, Wei Li2BCD, Xin Zhao1ABCDEFG, Jincheng Wang1ABCDEFG*, Yu Sun1BCD

DOI: 10.12659/MSM.902724

Med Sci Monit 2016; 22:5124-5130

Abstract

BACKGROUND: Different extents and locations of acetabular cartilage defect have been supposed to be a major cause of undesirable outcomes of periacetabular osteotomy (PAO) in patients with developmental dysplasia of the hip (DDH). This study aimed to verify whether different locations of cartilage deficiency affect the biomechanical environment in a three-dimensional model utilizing finite element analysis (FEA).

MATERIAL AND METHODS: We developed 3 DDH models – DDH-1 (normal shape), DDH-2 (superior defect), and DDH-3 (anterosuperior defect) – by deforming from a normal hip model. We also developed 3 PAO models – PAO-1, PAO-2, and PAO-3 – through rotating osteotomized fragments.

RESULTS: The maximum von Mises stress in the normal hip was 13.06 MPa. In the DDH-1 model, the maximum value on the load-bearing area decreased from 15.49 MPa pre-PAO to 14.28 MPa post-PAO, while stresses in the DDH-2 and DDH-3 models were higher than in the DDH-1 model, both pre-PAO and post-PAO (30.46 MPa to 26.04 MPa for DDH-2; 33.89 MPa to 27.48 MPa for DDH-3).

CONCLUSIONS: This study shows that, both pre- and post-PAO, different types of cartilage deficiency affect the biomechanical environment. Furthermore, in dysplastic hips, obtaining accurate three-dimensional information about the acetabular cartilage can contribute substantially to PAO decision making.

Keywords: Bone Diseases, Developmental, Cartilage, Articular, Finite Element Analysis, Osteotomy

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750