Reliability of computer-assisted periacetabular osteotomy using a minimally invasive approach

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Medical imaging

Background:

• Periacetabular osteotomy (PAO) is a key procedure for developmental hip dysplasia in young patients.
• The goal of PAO is to normalize hip joint geometry, reduce peak pressure, and prevent osteoarthritis.
• PAO is technically challenging, and computer navigation has not been previously validated for minimally invasive approaches.

Purpose of the Study:

• To validate the use of computer navigation in minimally invasive transsartorial periacetabular osteotomy.
• To assess the accuracy of computer-assisted angle measurements compared to manual measurements.
• To evaluate the impact of computer-assisted PAO on hip joint peak-pressure.

Main Methods:

• Computer-assisted PAO was performed on ten patients.
• Pre- and postoperative CT scans were used for 3D modeling and analysis.
• The Biomechanical Guidance System was employed for intra-operative measurements and calculations.
• Manual measurements were conducted for comparison, with statistical analysis including ICC and Bland-Altman plots.

Main Results:

• Computer navigation showed good agreement with manual angle measurements (ICC 0.94-0.98).
• Significant differences were noted for posterior sector and acetabular anteversion angles.
• Hip joint peak-pressure decreased by a mean of 13% postoperatively.

Conclusions:

• Computer navigation is a reliable tool for minimally invasive transsartorial PAO.
• The system demonstrates good agreement with manual measurements and effectively reduces joint peak-pressure.
• Further research with larger cohorts is needed to confirm the association with clinical outcomes.