Changes in chondrolabral mechanics, coverage, and congruency following peri-acetabular osteotomy for treatment of acetabular retroversion: A patient-specific finite element study
Autor: | Andrew E. Anderson, Jeffrey A. Weiss, Spencer J. Knight, Christine L. Abraham, Christopher L. Peters |
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Rok vydání: | 2017 |
Předmět: |
030222 orthopedics
Labrum business.industry medicine.medical_treatment Cartilage 0206 medical engineering 02 engineering and technology Mechanics Osteoarthritis Anatomy Patient specific Osteotomy medicine.disease 020601 biomedical engineering 03 medical and health sciences Femoral head 0302 clinical medicine medicine.anatomical_structure medicine Orthopedics and Sports Medicine Acetabular retroversion business Contact area |
Zdroj: | Journal of Orthopaedic Research. 35:2567-2576 |
ISSN: | 0736-0266 2567-2576 |
DOI: | 10.1002/jor.23566 |
Popis: | Using a validated finite element (FE) protocol, we quantified cartilage and labrum mechanics, congruency, and femoral coverage in five male patients before and after they were treated for acetabular retroversion with peri-acetabular osteotomy (PAO). Three-dimensional models of bone, cartilage, and labrum were generated from computed tomography (CT) arthrography images, acquired before and after PAO. Walking, stair-ascent, stair-descent, and rising from a chair were simulated. Cartilage and labrum contact stress, contact area, and femoral coverage were calculated overall and regionally. Mean congruency (average of local congruency values for FE nodes in contact) and peak congruency (most incongruent node in contact) were calculated overall and regionally. Load supported by the labrum was represented as a raw change in the ratio of the applied force transferred through the labrum and percent change following surgery (calculated overall only). Considering all activities, following PAO, mean acetabular cartilage contact stress increased medially, superiorly, and posteriorly; peak stress increased medially and posteriorly. Peak labrum stresses decreased overall and superiorly. Acetabular contact area decreased overall and laterally, and increased medially. Labral contact area decreased overall, but not regionally. Load to the labrum decreased. Femoral head coverage increased overall, anterolaterally, and posterolaterally, but decreased anteromedially. Mean congruency indicated the hip became less congruent overall, anteriorly, and posteriorly; peak congruency indicated a less congruent joint posteriorly. Clinical relevance Medialization of contact and reductions in labral loading following PAO may prevent osteoarthritis, but this procedure increases cartilage stresses, decreases contact area, and makes the hip less congruent, which may overload cartilage. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2567-2576, 2017. |
Databáze: | OpenAIRE |
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