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Periacetabular osteotomy with intraoperative computer-assisted modalities: a systematic review
Andrew J Curley1, Rachel E Bruning1, Saiswarnesh Padmanabhan1
1American Hip Institute, 999 East Touhy Ave, Suite 450, Chicago, IL 60018, USA.
Journal of Hip Preservation Surgery
|October 30, 2023
Summary
Computer-assisted surgery for periacetabular osteotomy (PAO) shows promise, potentially reducing radiation exposure. While outcomes are similar to traditional methods, further research is needed due to varied techniques.
Area of Science:
- Orthopedic Surgery
- Medical Technology
- Radiology
Background:
- The efficacy of intraoperative computer-assisted modalities for periacetabular osteotomy (PAO) is not well-established.
- Understanding perioperative and post-operative outcomes is crucial for evaluating these advanced techniques.
Purpose of the Study:
- To systematically review and evaluate the techniques and outcomes associated with intraoperative computer-assisted modalities in PAO.
Main Methods:
- A systematic review of clinical studies from PubMed, CINAHL/EBSCOHost, and Cochrane databases.
- Inclusion criteria focused on studies describing computer-assisted PAO techniques with at least 10 patients.
- Data extraction covered modalities, surgical techniques, patient demographics, radiographic and perioperative outcomes, PROs, complications, and subsequent surgeries.
Main Results:
- Nine studies involving 208 patients were included, utilizing intraoperative navigation, patient-specific guides, or both.
- Computer-assisted PAO showed significantly reduced intraoperative radiation exposure (P < 0.01) in three studies.
- Surgical times and blood loss were similar (P > 0.05) between computer-assisted and conventional PAO groups, with comparable post-operative angles.
Conclusions:
- Computer-assisted modalities, including navigation and patient-specific guides, offer potential benefits in PAO.
- These techniques demonstrated decreased intraoperative radiation exposure and comparable operative times and radiographic outcomes.
- Improved patient-reported outcomes (PROs) were noted, but results require cautious interpretation due to technique heterogeneity.
