Pelvic tilt affects superolateral coverage, but not superomedial coverage of the femoral head following periacetabular osteotomy.

Autor: Blackwell RD; John Sealy School of Medicine, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-1317, USA; Graduate Medical Education, Southeast Health, 1108 Ross Clark Circle, Dothan, AL 36301, USA., Parlamas S; Department of Orthopedic Surgery, McGovern Medical School, UTHealth Houston, 6431 Fannin, Houston, TX 77030, USA., Dunbar NJ; Department of Orthopedic Surgery, McGovern Medical School, UTHealth Houston, 6431 Fannin, Houston, TX 77030, USA., Ismaily SK; Department of Orthopedic Surgery, McGovern Medical School, UTHealth Houston, 6431 Fannin, Houston, TX 77030, USA., Rodriguez-Quintana D; Department of Orthopedic Surgery, McGovern Medical School, UTHealth Houston, 6431 Fannin, Houston, TX 77030, USA., Mansour AA; Department of Orthopedic Surgery, McGovern Medical School, UTHealth Houston, 6431 Fannin, Houston, TX 77030, USA., Han S; Department of Orthopedic Surgery, McGovern Medical School, UTHealth Houston, 6431 Fannin, Houston, TX 77030, USA. Electronic address: shuyang.han@uth.tmc.edu.
Jazyk: angličtina
Zdroj: Clinical biomechanics (Bristol, Avon) [Clin Biomech (Bristol, Avon)] 2024 Jan; Vol. 111, pp. 106160. Date of Electronic Publication: 2023 Dec 09.
DOI: 10.1016/j.clinbiomech.2023.106160
Abstrakt: Background: Pelvic tilt is an important sagittal parameter that varies greatly among individuals. The objective of this study was to quantify the effect of pelvic tilt on femoral head coverage and range of motion in a dysplastic population following periacetabular osteotomy.
Methods: Twenty-three dysplastic hips from 19 patients (17 female, 2 male) were included in this study. Three-dimensional models were reconstructed using pre-operative CT images, and patient-specific neutral pelvic tilt was obtained on an anteroposterior X-ray. Following a simulated periacetabular osteotomy, the pelvic tilt was changed from -15° to +15°, and the effects on femoral head coverage and hip range of motion was quantified using a customized MATLAB program.
Findings: Pelvic tilt did not significantly affect total femoral head coverage (P > 0.2). However, a 15° anterior tilt from neutral resulted in a 17.72 ± 9.45% increase in anterolateral coverage and a 23.96 ± 7.48% decrease in posterolateral coverage (P < 0.0001), as well as an 18.2 ± 8.4° loss of internal rotation at 90° of hip flexion. Contrarily, posterior pelvic tilt led to a 26.79 ± 9.04% reduction in anterolateral coverage (P < 0.0001) and an 18.02 ± 9.57% increase in posterolateral coverage (P < 0.0001), and the maximum internal rotation increased 11.8 ± 3.7°.
Interpretation: While pelvic tilt did not affect total femoral head coverage, it had a significant impact on the distribution of coverage within the superolateral region of the femoral head. Anterior pelvic tilt led to increased anterolateral coverage, but also had a negative impact on hip range of motion. An optimal surgical plan should achieve adequate coverage while not significantly limiting the patient's mobility.
Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Alfred A. Mansour reports a relationship with American Academy of Orthopaedic Surgeons that includes: board membership. Alfred A. Mansour reports a relationship with American Orthopaedic Society for Sports Medicine that includes: board membership. Alfred A. Mansour reports a relationship with Pediatric Orthopaedic Society of North America that includes: board membership. Alfred A. Mansour reports a relationship with Johnson & Johnson that includes: consulting or advisory. David Rodriguez-Quintana reports a relationship with Zimmer Biomet that includes: speaking and lecture fees. David Rodriguez-Quintana reports a relationship with Zimmer Biomet that includes: consulting or advisory.
(Published by Elsevier Ltd.)
Databáze: MEDLINE
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