Capsular Mechanics After Periacetabular Osteotomy for Hip Dysplasia.

Autor:	Ng KCG; Robarts Research Institute, Western University, London, Ontario, Canada.; Department of Medical Biophysics, Western University, London, Ontario, Canada.; Department of Medical Imaging, Western University, London, Ontario, Canada.; Department of Surgery, Western University, London, Ontario, Canada.; MSk Lab, Department of Surgery and Cancer, Imperial College London, London, United Kingdom., Bankes MJK; Department of Orthopaedics, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.; Fortius Clinic, London, United Kingdom., El Daou H; Department of Mechanical Engineering, Imperial College London, London, United Kingdom., Beaulé PE; Division of Orthopaedic Surgery, University of Ottawa, Ottawa, Ontario, Canada., Cobb JP; MSk Lab, Department of Surgery and Cancer, Imperial College London, London, United Kingdom., Jeffers JRT; Department of Mechanical Engineering, Imperial College London, London, United Kingdom.
Jazyk:	angličtina
Zdroj:	The Journal of bone and joint surgery. American volume [J Bone Joint Surg Am] 2022 Jun 01; Vol. 104 (11), pp. 1015-1023. Date of Electronic Publication: 2022 Feb 08.
DOI:	10.2106/JBJS.21.00405
Abstrakt:	Background: Hip dysplasia is characterized by insufficient acetabular coverage around the femoral head, which leads to instability, pain, and injury. Periacetabular osteotomy (PAO) aims to restore acetabular coverage and function, but its effects on capsular mechanics and joint stability are still unclear. The purpose of this study was to examine the effects of PAO on capsular mechanics and joint range of motion in dysplastic hips. Methods: Twelve cadaveric dysplastic hips (denuded to bone and capsule) were mounted onto a robotic tester and tested in multiple positions: (1) full extension, (2) neutral 0°, (3) flexion of 30°, (4) flexion of 60°, and (5) flexion of 90°. In each position, the hips underwent internal and external rotation, abduction, and adduction using 5 Nm of torque. Each hip then underwent PAO to reorient the acetabular fragment, preserving the capsular ligaments, and was retested. Results: The PAO reduced internal rotation in flexion of 90° (∆IR = -5°; p = 0.003), and increased external rotation in flexion of 60° (∆ER = +7°; p = 0.001) and flexion of 90° (∆ER = +11°; p = 0.001). The PAO also reduced abduction in extension (∆ABD = -10°; p = 0.002), neutral 0° (∆ABD = -7°; p = 0.001), and flexion of 30° (∆ABD = -8°; p = 0.001), but increased adduction in neutral 0° (∆ADD = +9°; p = 0.001), flexion of 30° (∆ADD = +11°; p = 0.002), and flexion of 60° (∆ADD = +11°; p = 0.003). Conclusions: PAO caused reductions in hip abduction and internal rotation but greater increases in hip adduction and external rotation. The osseous acetabular structure and capsule both play a role in the balance between joint mobility and stability after PAO. Competing Interests: Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJS/G919). (Copyright © 2022 by The Journal of Bone and Joint Surgery, Incorporated.)
Databáze:	MEDLINE
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