title: Theoretical Implications of Periacetabular Osteotomy in Various Dysplastic Acetabular Cartilage Defects as Determined by Finite Element Analysis.
abstract: BACKGROUND Different extents and locations of acetabular cartilage defect have been supposed to be a major cause of undesirable outcomes of periacetabular osteotomy (PAO) in patients with developmental dysplasia of the hip (DDH). This study aimed to verify whether different locations of cartilage deficiency affect the biomechanical environment in a three-dimensional model utilizing finite element analysis (FEA). MATERIAL AND METHODS We developed 3 DDH models - DDH-1 (normal shape), DDH-2 (superior defect), and DDH-3 (anterosuperior defect) - by deforming from a normal hip model. We also developed 3 PAO models - PAO-1, PAO-2, and PAO-3 - through rotating osteotomized fragments. RESULTS The maximum von Mises stress in the normal hip was 13.06 MPa. In the DDH-1 model, the maximum value on the load-bearing area decreased from 15.49 MPa pre-PAO to 14.28 MPa post-PAO, while stresses in the DDH-2 and DDH-3 models were higher than in the DDH-1 model, both pre-PAO and post-PAO (30.46 MPa to 26.04 MPa for DDH-2; 33.89 MPa to 27.48 MPa for DDH-3). CONCLUSIONS This study shows that, both pre- and post-PAO, different types of cartilage deficiency affect the biomechanical environment. Furthermore, in dysplastic hips, obtaining accurate three-dimensional information about the acetabular cartilage can contribute substantially to PAO decision making.
authors.affiliation: Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland).
authors.forename: Meng
authors.initials: M
authors.lastname: Xu
authors.affiliation: Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland).
authors.forename: Wenrui
authors.initials: W
authors.lastname: Qu
authors.affiliation: Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland).
authors.forename: Yanbing
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland).
authors.forename: Lei
authors.initials: L
authors.lastname: Zhong
authors.affiliation: Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland).
authors.forename: Zhe
authors.initials: Z
authors.lastname: Zhu
authors.affiliation: Department of Pediatrics, The First Hospital of Jilin University, Changchun, Jilin, China (mainland).
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland).
authors.forename: Xin
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland).
authors.forename: Jincheng
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland).
authors.forename: Yu
authors.initials: Y
authors.lastname: Sun
mesh_terms: D000077:Acetabulum / Q000473:pathology / Q000601:surgery*; D002356:Cartilage / Q000473:pathology* / Q000601:surgery; D020342:Finite Element Analysis; D006617:Hip Dislocation / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008954:Models, Biological; D010027:Osteotomy; D013314:Stress, Mechanical; D055815:Young Adult