M. De Kleuver et al., Three-dimensional displacement of the hip joint after triple pelvic osteotomy - A postmortem radiostereometric study, ACT ORTH SC, 69(6), 1998, pp. 585-589
Citations number
16
Categorie Soggetti
Ortopedics, Rehabilitation & Sport Medicine","da verificare
Triple pelvic osteotomy reorients the acetabulum relative to the pelvis in
order to improve acetabular coverage of the femoral head in cases of acetab
ular dysplasia. We undertook a radiostereometric analysis (RSA) on 6 osteot
omized cadaver hips to determine the actual three-dimensional reorientation
obtained.
The centers of the femoral head were all translated posteriorly between 11
and 41 mm, and distally up to 13 mm. 4 were lateralized up to 8 mm, and 2 w
ere medialized up to 5 mm. All acetabuli rotated anteriorly about the later
al to medial axis (X-axis), and 4 rotated outwards around the distal to pro
ximal axis (Y-axis). The correlations between measurements performed on con
ventional anteroposterior radiographs and the RSA measurements were poor: v
ariations in the lateral-medial direction ranged from -16 to +6 mm, and in
the distal-proximal direction between -10 and +12 mm.
The changes in orientations measured will significantly affect the load acr
oss the hip joint, since the dimensions of the pelvis change and the moment
arms of the muscles, their lengths and lines of action are changed as well
. We conclude that, with the procedures presently performed, the loads acro
ss the hip joint are bound to change, and that the reorientation can hardly
be checked with conventional radiographs.