title: Comparison of rotational acetabular osteotomy performed with navigation by surgeons with different levels of experience of osteotomies.
abstract: OBJECTIVE
  Rotational acetabular osteotomy (RAO) is used to treat developmental hip dysplasia (DDH). It requires detailed anatomical knowledge of the pelvic anatomy and three-dimensional cognitive skills. We addressed whether a computer navigation system combined with a preoperative computed tomography-based plan enabled surgeons to perform RAO safely and reliably through a mini-incision regardless of their level of experience with performing osteotomies.
  
  
  METHODS
  We enrolled 24 patients (25 hips) with DDH (radiographic grade 0 or 1 osteoarthritic changes: Tönnis classification). Using the navigation system, four surgeons performed RAO via a mini-incision transtrochanteric approach. Two experienced surgeons treated 15 patients (16 hips). Two surgeons with low-level RAO experience treated nine patients (9 hips). Operative data and clinical and radiographic outcomes were compared. Average follow-up was 3.2 years.
  
  
  RESULTS
  There were no significant differences in the (1) incision length, operation time, or intraoperative blood loss; (2) numerical pain rating scale score and Western Ontario and McMaster Universities Osteoarthritis Index Scale score at 1, 2 years, and at the latest follow-up; (3) preoperative and postoperative acetabular coverage of the femoral head, postoperative joint congruency, postoperative medial and distal femoral head displacement, or acetabular thickness; and (4) positional accuracy of iliac, pubic, and ischial osteotomy and accuracy of acetabular coverage of the femoral head.
  
  
  CONCLUSIONS
  Clinical and radiographic outcomes of RAO with navigation were not influenced by the surgeons' level of osteotomy experience.
authors: Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. masaki-tko@umin.ac.jp.
authors: Masaki
authors: M
authors: Takao
authors: Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors: Takashi
authors: T
authors: Nishii
authors: Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors: Takashi
authors: T
authors: Sakai
authors: Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors: Nobuhiko
authors: N
authors: Sugano
mesh_terms: D000077:Acetabulum / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D002983:Clinical Competence; D005260:Female; D005270:Femur Head / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D010388:Pelvis / Q000000981:diagnostic imaging; D057234:Preoperative Period; D015203:Reproducibility of Results; D012189:Retrospective Studies; D066231:Surgeons; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
keywords: Computed tomography; Developmental hip dysplasia; Navigation; Rotational acetabular osteotomy; Surgical experience