Three-dimensional acetabular reorientation during periacetabular osteotomy: an intraoperative navigation method using...

Area of Science:

• Orthopedic surgery
• Surgical navigation
• Hip reconstruction

Background:

• Bernese periacetabular osteotomy (PAO) is effective for acetabular dysplasia.
• Limited intraoperative visual control can lead to under/overcorrection or altered acetabular version.
• Residual dysplasia or femoroacetabular impingement may occur.

Purpose of the Study:

• To develop a simple navigation method for acetabular correction in all three planes during PAO.
• To provide intraoperative information on acetabular position and orientation.

Main Methods:

• An analog navigation system using a fixateur externe was developed.
• The system displays acetabular coordinates in coronal, sagittal, and transverse planes.
• Applied to 27 PAOs, primarily for lateral rotational correction.

Main Results:

• Improved mean lateral center edge angle (LCEA) from 16° to 34°.
• Corrected mean acetabular index (AI) from 15° to 2°.
• No postoperative acetabular retroversion observed in 27 cases.

Conclusions:

• Three-dimensional acetabular orientation control is crucial during PAO.
• The described fixateur externe method enables intraoperative 3D control.
• This technique aids in avoiding surgical correction errors and improving hip joint mechanics.