Periacetabular osteotomy through the pararectus approach: technical feasibility and control of fragment mobility by a validated surgical navigation system in a cadaver experiment.

Autor: Liu L; Institute for Surgical Technology and Biomechanics, University of Berne, Bern, Switzerland., Zheng G; Institute for Surgical Technology and Biomechanics, University of Berne, Bern, Switzerland., Bastian JD; Department of Orthopaedic Surgery, Inselspital, University of Berne, Bern, Switzerland., Keel MJ; Institute for Surgical Technology and Biomechanics, University of Berne, Bern, Switzerland., Nolte LP; Institute for Surgical Technology and Biomechanics, University of Berne, Bern, Switzerland., Siebenrock KA; Department of Orthopaedic Surgery, Inselspital, University of Berne, Bern, Switzerland., Ecker TM; Department of Orthopaedic Surgery, Inselspital, University of Berne, Bern, Switzerland. timo.ecker@insel.ch.
Jazyk: angličtina
Zdroj: International orthopaedics [Int Orthop] 2016 Jul; Vol. 40 (7), pp. 1389-96. Date of Electronic Publication: 2015 Jul 11.
DOI: 10.1007/s00264-015-2892-6
Abstrakt: Purpose: The pararectus approach has been validated for managing acetabular fractures. We hypothesised it might be an alternative approach for performing periacetabular osteotomy (PAO).
Methods: Using four cadaver specimens, we randomly performed PAO through either the pararectus or a modified Smith-Petersen (SP) approach. We assessed technical feasibility and safety. Furthermore, we controlled fragment mobility using a surgical navigation system and compared mobility between approaches. The navigation system's accuracy was tested by cross-examination with validated preoperative planning software.
Results: The pararectus approach is technically feasible, allowing for adequate exposure, safe osteotomies and excellent control of structures at risk. Fragment mobility is equal to that achieved through the SP approach. Validation of these measurements yielded a mean difference of less <1 mm without statistical significance.
Conclusion: Experimental data suggests the pararectus approach might be an alternative approach for performing PAO. Clinical validation is necessary to confirm these promising preliminary results.
Databáze: MEDLINE
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