Top

International Orthopaedics

Published in:

01-01-2017 | Original Paper

Variations in the obturator artery around the obturator foramen assessed by three-dimensional computed tomographic angiography and prevention of vascular-related complications in rotational acetabular osteotomy

Authors: Keizo Wada, Tomohiro Goto, Fumitake Tezuka, Shunsuke Tamaki, Daisuke Hamada, Takahiko Tsutsui, Koichi Sairyo

Published in: International Orthopaedics | Issue 1/2017

Abstract

Purpose

The aims of this study were (1) to evaluate the anatomical variations and locations of the obturator artery at the obturator foramen using computed tomographic (CT) angiography images and (2) to evaluate the pubic osteotomy site in rotational acetabular osteotomy using postoperative CT images in order to assess the relationship between the obturator artery and the pubic osteotomy site.

Methods

We examined a total of 196 hips in 98 consecutive Japanese patients for aim (1), and 38 consecutive patients who underwent rotational acetabular osteotomy for aim (2).

Results

The prevalence of arterial anastomosis of the obturator artery (corona mortis) was 14.3 %, with the obturator artery being located closer to the superior pubic ramus and the osteotomy site in these subjects.

Conclusions

Extensive care should be taken during rotational acetabular osteotomy in patients showing variations of the obturator artery with corona mortis.

Clohisy JC, Schutz AL, St John L, Schoenecker PL, Wright RW (2009) Periacetabular osteotomy: a systematic literature review. Clin Orthop Relat Res 467:2041–2052. doi:10.1007/s11999-009-0842-6 CrossRefPubMedPubMedCentral

Yasunaga Y, Yamasaki T, Ochi M (2012) Patient selection criteria for periacetabular osteotomy or rotational acetabular osteotomy. Clin Orthop Relat Res 470:3342–3354. doi:10.1007/s11999-012-2516-z CrossRefPubMedPubMedCentral

Siebenrock KA, Schaller C, Tannast M, Keel M, Büchler L (2014) Anteverting periacetabular osteotomy for symptomatic acetabular retroversion: results at ten years. J Bone Joint Surg Am 96:1785–1792. doi:10.2106/JBJS.M.00842 CrossRefPubMed

Jingushi S, Ohfuji S, Sofue M et al (2010) Multiinstitutional epidemiological study regarding osteoarthritis of the hip in Japan. J Orthop Sci 15:626–631. doi:10.1007/s00776-010-1507-8 CrossRefPubMed

Jingushi S, Ohfuji S, Sofue M et al (2011) Osteoarthritis hip joints in Japan: involvement of acetabular dysplasia. J Orthop Sci 16:156–164. doi:10.1007/s00776-011-0025-7 CrossRefPubMed

Ninomiya S, Tagawa H (1984) Rotational acetabular osteotomy for the dysplastic hip. J Bone Joint Surg Am 66:430–436CrossRefPubMed

Takatori Y, Ninomiya S, Nakamura S, Morimoto S, Moro T, Nagai I, Mabuchi A (2001) Long-term results of rotational acetabular osteotomy in patients with slight narrowing of the joint space on preoperative radiographic findings. J Orthop Sci 6:137–140. doi:10.1007/s0077610060137 CrossRefPubMed

Ito H, Tanino H, Yamanaka Y, Minami A, Matsuno T (2011) Intermediate to long-term results of periacetabular osteotomy in patients younger and older than forty years of age. J Bone Joint Surg Am 93:1347–1354. doi:10.2106/JBJS.J.01059 CrossRefPubMed

Kaneuji A, Sugimori T, Ichiseki T, Fukui K, Takahashi E, Matsumoto T (2015) Rotational acetabular osteotomy for osteoarthritis with acetabular dysplasia: conversion rate to total hip arthroplasty within twenty years and osteoarthritis progression after a minimum of twenty years. J Bone Joint Surg Am 97:726–732. doi:10.2106/JBJS.N.00667 CrossRefPubMed

10.

Hasegawa Y, Iwase T, Kitamura S, Yamauchi Ki K, Sakano S, Iwata H (2002) Eccentric rotational acetabular osteotomy for acetabular dysplasia: follow-up of one hundred and thirty-two hips for five to ten years. J Bone Joint Surg Am 84-A:404–410CrossRefPubMed

11.

Davey JP, Santore RF (1999) Complications of periacetabular osteotomy. Clin Orthop Relat Res 33-37

12.

Matta JM, Stover MD, Siebenrock K (1999) Periacetabular osteotomy through the Smith-Petersen approach. Clin Orthop Relat Res 21–32

13.

Brenøe A-S, Andersen PE, Overgaard S (2006) Endovascular embolisation of severe bleeding in connection with periacetabular osteotomy. Ugeskr Laeg 168:1453–1454PubMed

14.

Thawrani D, Sucato DJ, Podeszwa DA, DeLaRocha A (2010) Complications associated with the Bernese periacetabular osteotomy for hip dysplasia in adolescents. J Bone Joint Surg Am 92:1707–1714. doi:10.2106/JBJS.I.00829 CrossRefPubMed

15.

Tornetta P, Hochwald N, Levine R (1996) Corona mortis. Incidence and location. Clin Orthop Relat Res 97–101

16.

Gilroy AM, Hermey DC, DiBenedetto LM, Marks SC Jr, Page DW, Lei QF (1997) Variability of the obturator vessels. Clin Anat 10:328–332. doi:10.1002/(SICI)1098-2353(1997)10:5<328::AID-CA7>3.0.CO;2-M CrossRefPubMed

17.

Smith JC, Gregorius JC, Breazeale BH, Watkins GE (2009) The corona mortis, a frequent vascular variant susceptible to blunt pelvic trauma: identification at routine multidetector CT. J Vasc Interv Radiol 20:455–460. doi:10.1016/j.jvir.2009.01.007 CrossRefPubMed

18.

Karakurt L, Karaca I, Yilmaz E, Burma O, Serin E (2002) Corona mortis: incidence and location. Arch Orthop Trauma Surg 122:163–164. doi:10.1007/s004020100341 CrossRefPubMed

19.

Okcu G, Erkan S, Yercan HS, Ozic U (2004) The incidence and location of corona mortis: a study on 75 cadavers. Acta Orthop Scand 75:53–55. doi:10.1080/00016470410001708100 CrossRefPubMed

20.

Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174CrossRefPubMed

21.

Naito M, Nakamura Y (2014) Curved periacetabular osteotomy for the treatment of dysplastic hips. Clin Orthop Surg 6:127–137. doi:10.4055/cios.2014.6.2.127 CrossRefPubMedPubMedCentral

22.

Kinoshita K, Naito M, Shiramizu K, Kamada S (2011) Prevention of obturator artery injury during pubic osteotomy in periacetabular osteotomy. Curr Orthop Pract 22(2):171–175CrossRef

23.

Kamada S, Naito M, Shiramizu K, Nakamura Y, Kinoshita K (2011) Is the obturator artery safe when performing ischial osteotomy during periacetabular osteotomy? Int Orthop 35:503–506. doi:10.1007/s00264-010-1064-y CrossRefPubMed

Title: Variations in the obturator artery around the obturator foramen assessed by three-dimensional computed tomographic angiography and prevention of vascular-related complications in rotational acetabular osteotomy
Authors: Keizo Wada
Tomohiro Goto
Fumitake Tezuka
Shunsuke Tamaki
Daisuke Hamada
Takahiko Tsutsui
Koichi Sairyo
Publication date: 01-01-2017
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 1/2017
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-016-3268-2

At a glance: The STEP trials

Springer Medicine

Variations in the obturator artery around the obturator foramen assessed by three-dimensional computed tomographic angiography and prevention of vascular-related complications in rotational acetabular osteotomy

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2017

One-stage bilateral versus unilateral short-stem total hip arthroplasty: comparison of migration patterns using “Ein-Bild-Roentgen-Analysis Femoral-Component-Analysis”

Simultaneous open reduction and internal fixation and total hip arthroplasty for the treatment of osteoporotic acetabular fractures

Management of chronic neglected lateral condyle elbow non-union in adults: functional results of a cohort study and a proposed treatment algorithm

Effects of multi-site infiltration analgesia on pain management and early rehabilitation compared with femoral nerve or adductor canal block for patients undergoing total knee arthroplasty: a prospective randomized controlled trial

Total ankle arthroplasty versus ankle arthrodesis for the treatment of end-stage ankle arthritis: a meta-analysis of comparative studies

Autologous osteochondral mosaicplasty in osteochondritis dissecans of the patella in adolescents