COMPARATIVE STUDY ON BIOMECHANICAL EFFECTS BETWEEN ROTATIONAL ACETABULAR OSTEOTOMY AND Chiari OSTEOTOMY IN DEVELOPMENTAL DYSPLASIA OF HIP_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

FU Ming ¹ , ZHANG Zhiqi ¹ , XIANG Shanshan ² , LIU Jin ¹ , HUANG Guangxin ¹

1Department of Joint Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou Guangdong, 510080, P.R.China;;
2Department of Orthopaedic Surgery, the Affiliated Jiangmen Hospital of Sun Yat-sen University. Corresponding author: FU Ming, E-mail: ming_fu@126.com;

Corresponding author：

Keywords：

Developmental dysplasia of the hip; Rotational acetabular osteotomy; Chiari osteotomy; Hip stress

DOI：

10.7507/1002-1892.20130142

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Objective To compare the biomechanical effects between rotational acetabular osteotomy and Chiari osteotomy for developmental dysplasia of the hip (DDH) by biomechanical test. Methods Sixteen DDH models of 8 human cadaver specimens were prepared by resecting the upper edge and posterior edge of acetabulum. And the Wiberg central-edge angle (CE) of the DDH model was less than 20°. Then the rotational acetabular osteotomy was performed on the left hip and Chiari osteotomy on the right hip. When 600 N loading was loaded at 5 mm/minute by a material testing machine, the strain values of normal specimens, DDH specimens, and 2 models after osteotomies were measured. Results In normal specimens, the strain values of the left and right hips were 845.63 ± 533.91 and 955.94 ± 837.42 respectively, while the strain values were 1 439.03 ± 625.23 and 1 558.75 ± 1 009.46 respectively in DDH specimens, which was about 2 times that of normal hips. The morphology and X-ray examinations indicated that the DDH model was successfully established. The strain value was 574.94 ± 430.88 after rotational acetabular osteotomy, and was significantly lower than that of DDH specimens (t=4.176, P=0.004); the strain value was 1 614.81 ± 932.67 after Chiari osteotomy, showing no significant difference when compared with that of DDH specimens (t=0.208, P=0.841). The strain value relieved by rotational acetabular osteotomy was significantly higher than that by Chiari osteotomy (t= — 2.548, P=0.023). Conclusion Rotational acetabular osteotomy is better than Chiari osteotomy in relieving hip joint stress of DDH.

Citation： FU Ming,ZHANG Zhiqi,XIANG Shanshan,LIU Jin,HUANG Guangxin. COMPARATIVE STUDY ON BIOMECHANICAL EFFECTS BETWEEN ROTATIONAL ACETABULAR OSTEOTOMY AND Chiari OSTEOTOMY IN DEVELOPMENTAL DYSPLASIA OF HIP. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(6): 641-644. doi: 10.7507/1002-1892.20130142 Copy

1.	Maheshwari R, Madan SS. Pelvic osteotomy techniques and comparative effects on biomechanics of the hip: a kinematic study. Orthopedics, 2011, 34(12): e821-e826.
2.	Lee CB, Millis MB. Alternatives to periacetabular osteotomy for adult acetabular dysplasia. Instr Course Lect, 2013, 62: 287-295.
3.	Bittersohl B, Hosalkar HS, Wenger DR. Surgical treatment of hip dysplasia in children and adolescents. Orthop Clin North Am, 2012, 43(3): 301-315.
4.	Bergmann G, Deuretzbacher G, Heller M, et al. Hip contact forces and gait patterns from routine activities. J Biomech, 2001, 34(7): 859-871.
5.	Michaeli DA, Murphy SB, Hipp JA. Comparison of predicted and measured contact pressures in normal and dysplastic hips. Med Eng Phys, 1997, 19(2): 180-186.
6.	Zhang Z, Fu M, Kang Y, et al. Upward and inward displacements of the acetabular component increase stress on femoral head in single endoprothesis models. Int Orthop, 2010, 34(4): 479-483.
7.	Østbyhaug PO, Klaksvik J, Romundstad P, et al. An in vitro study of the strain distribution in human femora with anatomical and customised femoral stems. J Bone Joint Surg (Br), 2009, 91(5): 676-682.
8.	Giori NJ, Trousdale RT. Acetabular retroversion is associated with osteoarthritis of the hip. Clin Orthop Relat Res, 2003, (417): 263-269.
9.	Millis MB, Murphy SB, Poss R. Osteotomies about the hip for the prevention and treatment of osteoarthrosis. Instr Course Lect, 1996, 45: 209-226.
10.	Hartofilakidis G, Karachalios T, Stamos KG. Epidemiology, demographics, and natural history of congenital hip disease in adults. Orthopedics, 2000, 23(8): 823-827.
11.	Aldinger PR, Thomsen M, Mau H, et al. Cementless Spotorno tapered titanium stems: excellent 10-15-year survival in 141 young patients. Acta Orthop Scand, 2003, 74(3): 253-258.
12.	Hartofilakidis G, Karachalios T, Zacharakis N. Charnley low friction arthroplasty in young patients with osteoarthritis. A 12- to 24-year clinical and radiographic followup study of 84 cases. Clin Orthop Relat Res, 1997, (341): 51-54.
13.	Yasunaga Y, Ochi M, Shimogaki K, et al. Rotational acetabular osteotomy for hip dysplasia: 61 hips followed for 8-15 years. Acta Orthop Scand, 2004, 75(1): 10-15.
14.	Yasunaga Y, Takahashi K, Ochi M, et al. Rotational acetabular osteotomy in patients forty-six years of age or older: comparison with younger patients. J Bone Joint Surg (Am), 2003, 85-A(2): 266-272.
15.	Ito H, Tanino H, Yamanaka Y, et al. The Chiari pelvic osteotomy for patients with dysplastic hips and poor joint congruency: long-term follow-up. J Bone Joint Surg (Br), 2011, 93(6): 726-731.
16.	Vukasinovic Z, Spasovski D, Slavkovic N, et al. Chiari pelvic osteotomy in the treatment of adolescent hip disorders: possibilities, limitations and complications. Int Orthop, 2011, 35(8): 1203-1208.
17.	Kotz R, Chiari C, Hofstaetter JG, et al. Long-term experience with Chiari’s osteotomy. Clin Orthop Relat Res, 2009, 467(9): 2215-2220.
18.	Iliescu N, Pastrama SD, Gruionu LG, et al. Biomechanical changes of hip joint following different types of corrective osteotomy—photoelastic studies. Acta Bioeng Biomech, 2008, 10(3): 65-71.
19.	Karami M, Fitoussi F, Ilharreborde B, et al. The results of Chiari pelvic osteotomy in adolescents with a brief literature review. J Child Orthop, 2008, 2(1): 63-68.
20.	Li Z, Yu S, Hou C, et al. A comparison of biomechanical changes on femoral head following rotational acetabular osteotomy and eccentric rotational acetabular osteotomy in normal cadaveric hip. Eur J Orthop Surg Traumatol, 2013. [Epub ahead of print].
21.	Maruyama M, Wakabayashi S, Tensho K. Less invasive rotational acetabular osteotomy for hip dysplasia. Clin Orthop Relat Res, 2013, 471(4): 1263-1270.
22.	陈晓东, 崔一民, 沈超, 等. 髋臼周围截骨术治疗髋关节发育不良. 中华骨科杂志, 2010, 30(2): 143-147.
23.	廉永云, 刘雪峰, 逯代锋. 等. 髋臼周围旋转截骨术联合髋关节镜治疗中青年髋臼发育不良. 中国修复重建外科杂志, 2011, 25(7): 821-825.
24.	Nozawa M, Maezawa K, Matsuda K, et al. Rotational acetabular osteotomy for advanced osteoarthritis of the hip joint with acetabular dysplasia. Int Orthop, 2009, 33(6): 1549-1553.
25.	Nozawa M, Maezawa K, Matsuda K, et al. Rotational acetabular osteotomy for secondary osteoarthritis after surgery for developmental dysplasia of the hip. HSS J, 2009, 5(2): 137-142.
26.	Shimogaki K, Yasunaga Y, Ochi M. A histological study of articular cartilage after rotational acetabular osteotomy for hip dysplasia. J Bone Joint Surg (Br), 2005, 87(7): 1019-1023.

1. Maheshwari R, Madan SS. Pelvic osteotomy techniques and comparative effects on biomechanics of the hip: a kinematic study. Orthopedics, 2011, 34(12): e821-e826.
2. Lee CB, Millis MB. Alternatives to periacetabular osteotomy for adult acetabular dysplasia. Instr Course Lect, 2013, 62: 287-295.
3. Bittersohl B, Hosalkar HS, Wenger DR. Surgical treatment of hip dysplasia in children and adolescents. Orthop Clin North Am, 2012, 43(3): 301-315.
4. Bergmann G, Deuretzbacher G, Heller M, et al. Hip contact forces and gait patterns from routine activities. J Biomech, 2001, 34(7): 859-871.
5. Michaeli DA, Murphy SB, Hipp JA. Comparison of predicted and measured contact pressures in normal and dysplastic hips. Med Eng Phys, 1997, 19(2): 180-186.
6. Zhang Z, Fu M, Kang Y, et al. Upward and inward displacements of the acetabular component increase stress on femoral head in single endoprothesis models. Int Orthop, 2010, 34(4): 479-483.
7. Østbyhaug PO, Klaksvik J, Romundstad P, et al. An in vitro study of the strain distribution in human femora with anatomical and customised femoral stems. J Bone Joint Surg (Br), 2009, 91(5): 676-682.
8. Giori NJ, Trousdale RT. Acetabular retroversion is associated with osteoarthritis of the hip. Clin Orthop Relat Res, 2003, (417): 263-269.
9. Millis MB, Murphy SB, Poss R. Osteotomies about the hip for the prevention and treatment of osteoarthrosis. Instr Course Lect, 1996, 45: 209-226.
10. Hartofilakidis G, Karachalios T, Stamos KG. Epidemiology, demographics, and natural history of congenital hip disease in adults. Orthopedics, 2000, 23(8): 823-827.
11. Aldinger PR, Thomsen M, Mau H, et al. Cementless Spotorno tapered titanium stems: excellent 10-15-year survival in 141 young patients. Acta Orthop Scand, 2003, 74(3): 253-258.
12. Hartofilakidis G, Karachalios T, Zacharakis N. Charnley low friction arthroplasty in young patients with osteoarthritis. A 12- to 24-year clinical and radiographic followup study of 84 cases. Clin Orthop Relat Res, 1997, (341): 51-54.
13. Yasunaga Y, Ochi M, Shimogaki K, et al. Rotational acetabular osteotomy for hip dysplasia: 61 hips followed for 8-15 years. Acta Orthop Scand, 2004, 75(1): 10-15.
14. Yasunaga Y, Takahashi K, Ochi M, et al. Rotational acetabular osteotomy in patients forty-six years of age or older: comparison with younger patients. J Bone Joint Surg (Am), 2003, 85-A(2): 266-272.
15. Ito H, Tanino H, Yamanaka Y, et al. The Chiari pelvic osteotomy for patients with dysplastic hips and poor joint congruency: long-term follow-up. J Bone Joint Surg (Br), 2011, 93(6): 726-731.
16. Vukasinovic Z, Spasovski D, Slavkovic N, et al. Chiari pelvic osteotomy in the treatment of adolescent hip disorders: possibilities, limitations and complications. Int Orthop, 2011, 35(8): 1203-1208.
17. Kotz R, Chiari C, Hofstaetter JG, et al. Long-term experience with Chiari’s osteotomy. Clin Orthop Relat Res, 2009, 467(9): 2215-2220.
18. Iliescu N, Pastrama SD, Gruionu LG, et al. Biomechanical changes of hip joint following different types of corrective osteotomy—photoelastic studies. Acta Bioeng Biomech, 2008, 10(3): 65-71.
19. Karami M, Fitoussi F, Ilharreborde B, et al. The results of Chiari pelvic osteotomy in adolescents with a brief literature review. J Child Orthop, 2008, 2(1): 63-68.
20. Li Z, Yu S, Hou C, et al. A comparison of biomechanical changes on femoral head following rotational acetabular osteotomy and eccentric rotational acetabular osteotomy in normal cadaveric hip. Eur J Orthop Surg Traumatol, 2013. [Epub ahead of print].
21. Maruyama M, Wakabayashi S, Tensho K. Less invasive rotational acetabular osteotomy for hip dysplasia. Clin Orthop Relat Res, 2013, 471(4): 1263-1270.
22. 陈晓东, 崔一民, 沈超, 等. 髋臼周围截骨术治疗髋关节发育不良. 中华骨科杂志, 2010, 30(2): 143-147.
23. 廉永云, 刘雪峰, 逯代锋. 等. 髋臼周围旋转截骨术联合髋关节镜治疗中青年髋臼发育不良. 中国修复重建外科杂志, 2011, 25(7): 821-825.
24. Nozawa M, Maezawa K, Matsuda K, et al. Rotational acetabular osteotomy for advanced osteoarthritis of the hip joint with acetabular dysplasia. Int Orthop, 2009, 33(6): 1549-1553.
25. Nozawa M, Maezawa K, Matsuda K, et al. Rotational acetabular osteotomy for secondary osteoarthritis after surgery for developmental dysplasia of the hip. HSS J, 2009, 5(2): 137-142.
26. Shimogaki K, Yasunaga Y, Ochi M. A histological study of articular cartilage after rotational acetabular osteotomy for hip dysplasia. J Bone Joint Surg (Br), 2005, 87(7): 1019-1023.

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Chinese Journal of Reparative and Reconstructive Surgery

COMPARATIVE STUDY ON BIOMECHANICAL EFFECTS BETWEEN ROTATIONAL ACETABULAR OSTEOTOMY AND Chiari OSTEOTOMY IN DEVELOPMENTAL DYSPLASIA OF HIP

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