The truth of CT-based navigation assisted curved periacetabular osteotomy

4 pages•Published: March 8, 2024

Abstract

Curved periacetabular osteotomy (CPO) is technically demanding procedure because we have to enter the osteotomy site from inside of pelvis without direct view of hip joint. To achieve this tricky procedure without troubles such as posterior column fracture or intraarticular osteotomy, we used CT-based navigation. To investigate accuracy of osteotomy in patients who underwent CT-based navigation assisted CPO, pre- and post-operative CT images were measured with three dimensional (3D) image analyzing software. The 3D image analysis demonstrated that our osteotomies were not so accurate because each standard deviation of measurement values were not small. Our clinical data showed that 73% patients developed cartilage degeneration after CPO in postoperative X-ray films. Painful hips were observed in 26.9% and one hip was converted to total hip arthroplasty within 3 years after CPO. The first reason of these inaccuracy and unsatisfaction of our CPO was lack of consensus for true target zone of rotated acetabulum in CPO. We determined each final acetabular position by checking with intraoperative fluoroscopic 2D images. The second reason was that the current CT- based navigation could only assist osteotomy of ilium and quadrilateral surface. In addition, our navigation could not assist acetabular rotation in real time. Further improvements are required to achieve more accurate and successful CPO with computer assisted surgery.

Keyphrases: Computer Tomography, curved periacetabular osteotomy, femoral head coverage, image analysis, Navigation, three dimensions

In: Joshua W Giles (editor). Proceedings of The 22nd Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery, vol 6, pages 115--118

Links:	https://easychair.org/publications/paper/5lVB
	https://doi.org/10.29007/hk56