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Three-Dimensional Preoperative Virtual Planning in Derotational Proximal Femoral Osteotomy

Three-Dimensional Preoperative Virtual Planning in Derotational Proximal Femoral Osteotomy

Published on: February 17, 2023

Three-dimensional kinetic simulation before and after rotational acetabular osteotomy.

Shintaro Iwai¹, Tamon Kabata, Toru Maeda

¹Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, 920-8641, Japan.

Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association

|February 19, 2014

Summary

Rotational acetabular osteotomy (RAO) may increase the risk of secondary femoroacetabular impingement (FAI). Postoperative simulations show reduced range of motion and increased impingement, particularly in internal rotation.

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Area of Science:

Orthopedic surgery
Biomechanics
Hip joint imaging

Background:

Secondary femoroacetabular impingement (FAI) is a significant cause of clinical failure after periacetabular osteotomy.
Assessing the impact of range of motion (ROM) on FAI development post-rotational acetabular osteotomy (RAO) is crucial.

Purpose of the Study:

To evaluate the effect of RAO on hip range of motion and the potential for secondary FAI.
To simulate FAI development before and after RAO using 3D-CT.

Main Methods:

Evaluated 12 hips post-RAO and 12 normal hips.
Measured morphological parameters including acetabular anteversion and CE angles.
Performed 3D-CT impingement simulations to assess ROM limitations and lesion development.

Main Results:

Postoperative RAO improved acetabular coverage but showed persistent crossover signs.
Simulations revealed decreased ROM in flexion, abduction, and internal rotation post-RAO.
Increased impingement, particularly within 45° internal rotation at 90° flexion, was observed postoperatively, with anterosuperior acetabular lesions.

Conclusions:

RAO may lead to increased secondary FAI due to reduced postoperative ROM.
Impingement risk, especially in internal rotation, appears elevated after RAO.
Further investigation into ROM limitations and FAI development post-RAO is warranted.