Biomechanical Optimization-Based Planning of Periacetabular Osteotomy.

Liu, Li; Siebenrock, Klaus; Nolte, Lutz-P.; Zheng, Guoyan (2018). Biomechanical Optimization-Based Planning of Periacetabular Osteotomy. Advances in experimental medicine and biology, 1093, pp. 157-168. Springer 10.1007/978-981-13-1396-7_13

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Modern computerized planning tools for periacetabular osteotomy (PAO) use either morphology-based or biomechanics-based methods. The latter rely on estimation of peak contact pressures and contact areas using either patient-specific or constant thickness cartilage models. We performed a finite element analysis investigating the optimal reorientation of the acetabulum in PAO surgery based on simulated joint contact pressures and contact areas using patient-specific cartilage model. Furthermore we investigated the influences of using patient-specific cartilage model or constant thickness cartilage model on the biomechanical simulation results. Ten specimens with hip dysplasia were used in this study. Image data were available from CT arthrography studies. Bone models were reconstructed. Mesh models for the patient-specific cartilage were defined and subsequently loaded under previously reported boundary and loading conditions. Peak contact pressures and contact areas were estimated in the original position. Afterward we used validated preoperative planning software to change the acetabular inclination by an increment of 5° and measured the lateral center-edge angle (LCE) at each reorientation position. The position with the largest contact area and the lowest peak contact pressure was defined as the optimal position. In order to investigate the influence of using patient-specific cartilage model or constant thickness cartilage model on the biomechanical simulation results, the same procedure was repeated with the same bone models but with a cartilage mesh of constant thickness. Comparison of the peak contact pressures and the contact areas between these two different cartilage models showed that good correlation between these two cartilage models for peak contact pressures (r = 0.634 ∈[0.6, 0.8], p < 0.001) and contact areas (r = 0.872 > 0.8, p < 0.001). For both cartilage models, the largest contact areas and the lowest peak pressures were found at the same position. Our study is the first study comparing peak contact pressures and contact areas between patient-specific and constant thickness cartilage models during PAO planning. Good correlation for these two models was detected. Computer-assisted planning with FE modeling using constant thickness cartilage models might be a promising PAO planning tool when a conventional CT is available.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute for Surgical Technology & Biomechanics ISTB
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery

UniBE Contributor:

Siebenrock, Klaus-Arno; Nolte, Lutz-Peter and Zheng, Guoyan

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health

ISSN:

0065-2598

Publisher:

Springer

Language:

English

Submitter:

Kathrin Aeschlimann

Date Deposited:

04 Oct 2019 10:27

Last Modified:

04 Oct 2019 10:27

Publisher DOI:

10.1007/978-981-13-1396-7_13

PubMed ID:

30306480

Uncontrolled Keywords:

Biomechanical simulation Finite element analysis (FEA) Hip dysplasia Image-guided surgery Joint preservation surgery Periacetabular osteotomy (PAO) Planning

URI:

https://boris.unibe.ch/id/eprint/131520

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