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Journal of Orthopaedic Surgery and Research

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Open Access 01-12-2016 | Research article

Clinical evaluation of a biomechanical guidance system for periacetabular osteotomy

Authors: Ryan J. Murphy, Robert S. Armiger, Jyri Lepistö, Mehran Armand

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2016

Abstract

Background

Populations suffering from developmental dysplasia of the hip typically have reduced femoral coverage and experience joint pain while walking. Periacetabular osteotomy (PAO) is one surgical solution that realigns the acetabular fragment. This challenging surgery has a steep learning curve. Existing navigation systems for computer-assisted PAO neither track the released fragment nor offer the means to assess fragment location. An intraoperative workstation—the biomechanical guidance system (BGS)—developed for PAO incorporates intraoperative fragment tracking and acetabular characterization through radiographic angles and joint biomechanics. In this paper, we investigate the accuracy and effectiveness of the BGS for bone fragment tracking and acetabular characterization in clinical settings as compared to conventional techniques and postoperative assessments. We also report the issues encountered and our remedies when using the BGS in the clinical setting.

Methods

Eleven consecutive patients (aged 22–48, mean 34, years) underwent 12 PAO surgeries (one bilateral surgery) where the BGS collected information on acetabular positioning. These measurements were compared with postoperative CT data and manual measurements made intraoperatively.

Results

No complications were reported during surgery, with surgical time—95–210 (mean 175) minutes—comparable to reported data for the conventional approach. The BGS-measured acetabular positioning showed strong agreement with postoperative CT measurements (−0.3–9.2, mean 3.7, degrees), whereas larger differences occurred between the surgeon’s intraoperative manual measurements and postoperative CT measurements (−2.8–21.3, mean 10.5, degrees).

Conclusions

The BGS successfully tracked the acetabular fragment in a clinical environment without introducing complications to the surgical workflow. Accurate 3D positioning of the acetabulum may provide more information intraoperatively (e.g., anatomical angles and biomechanics) without adversely impacting the surgery to better understand potential patient outcomes.

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Title: Clinical evaluation of a biomechanical guidance system for periacetabular osteotomy
Authors: Ryan J. Murphy
Robert S. Armiger
Jyri Lepistö
Mehran Armand
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: Journal of Orthopaedic Surgery and Research / Issue 1/2016
Electronic ISSN: 1749-799X
DOI: https://doi.org/10.1186/s13018-016-0372-3

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Springer Medicine

Clinical evaluation of a biomechanical guidance system for periacetabular osteotomy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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