Preoperative Planning of Periacetabular Osteotomy (PAO)

Ecker, Timo; Liu, Li; Zheng, Guoyan; Albers, Christoph; Siebenrock, Klaus-Arno (2016). Preoperative Planning of Periacetabular Osteotomy (PAO). In: Zheng, Guoyan; Li, Shuo (eds.) Computational Radiology for Orthopaedic Interventions. Lecture Notes in Computational Vision and Biomechanics: Vol. 23 (pp. 151-171). Cham: Springer 10.1007/978-3-319-23482-3_8

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Pelvic osteotomies improve containment of the femoral head in cases of developmental dysplasia of the hip or in femoroacetabular impingement due to acetabular retroversion. In the evolution of osteotomies, the Ganz Periacetabular Osteotomy (PAO) is among the complex reorientation osteotomies and allows for complete mobilization of the acetabulum without compromising the integrity of the pelvic ring. For the complex reorientation osteotomies, preoperative planning of the required acetabular correction is an important step, due to the need to comprehend the three-dimensional (3D) relationship between acetabulum and femur. Traditionally, planning was performed using conventional radiographs in different projections, reducing the 3D problem to a two-dimensional one. Known disturbance variables, mainly tilt and rotation of the pelvis make assessment by these means approximate at the most. The advent of modern enhanced computation skills and new imaging techniques gave room for more sophisticated means of preoperative planning. Apart from analysis of acetabular geometry on conventional x-rays by sophisticated software applications, more accurate assessment of coverage and congruency and thus amount of correction necessary can be performed on multiplanar CT images. With further evolution of computer-assisted orthopaedic surgery, especially the ability to generate 3D models from the CT data, examiners were enabled to simulate the in vivo situation in a virtual in vitro setting. Based on this ability, different techniques have been described. They basically all employ virtual definition of an acetabular fragment. Subsequently reorientation can be simulated using either 3D calculation of standard parameters of femoroacetabular morphology, or joint contact pressures, or a combination of both. Other techniques employ patient specific implants, templates or cutting guides to achieve the goal of safe periacetabular osteotomies. This chapter will give an overview of the available techniques for planning of periacetabular osteotomy.

Item Type:

Book Section (Book Chapter)

Division/Institute:

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

Graduate School:

Graduate School for Cellular and Biomedical Sciences (GCB)

UniBE Contributor:

Ecker, Timo Michael, Liu, Li, Zheng, Guoyan, Albers, Christoph E., Siebenrock, Klaus-Arno

Subjects:

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

ISSN:

2212-9391

ISBN:

978-3-319-23481-6

Series:

Lecture Notes in Computational Vision and Biomechanics

Publisher:

Springer

Language:

English

Submitter:

Li Liu

Date Deposited:

09 Feb 2016 10:33

Last Modified:

02 Mar 2023 23:27

Publisher DOI:

10.1007/978-3-319-23482-3_8

BORIS DOI:

10.7892/boris.75231

URI:

https://boris.unibe.ch/id/eprint/75231

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