Reliability of computer-assisted periacetabular osteotomy using a minimally invasive approach
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Reliability of computer-assisted periacetabular osteotomy using a minimally invasive approach. / De Raedt, Sepp; Mechlenburg, Inger; Stilling, Maiken; Rømer, Lone; Murphy, Ryan J; Armand, Mehran; Lepistö, Jyri; de Bruijne, Marleen; Søballe, Kjeld.
In: International Journal of Computer Assisted Radiology and Surgery, Vol. 13, No. 12, 2018, p. 2021-2028.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Reliability of computer-assisted periacetabular osteotomy using a minimally invasive approach
AU - De Raedt, Sepp
AU - Mechlenburg, Inger
AU - Stilling, Maiken
AU - Rømer, Lone
AU - Murphy, Ryan J
AU - Armand, Mehran
AU - Lepistö, Jyri
AU - de Bruijne, Marleen
AU - Søballe, Kjeld
PY - 2018
Y1 - 2018
N2 - BACKGROUND: Periacetabular osteotomy (PAO) is the treatment of choice for younger patients with developmental hip dysplasia. The procedure aims to normalize the joint configuration, reduce the peak-pressure, and delay the development of osteoarthritis. The procedure is technically demanding and no previous study has validated the use of computer navigation with a minimally invasive transsartorial approach.METHODS: Computer-assisted PAO was performed on ten patients. Patients underwent pre- and postoperative computed tomography (CT) scanning with a standardized protocol. Preoperative preparation consisted of outlining the lunate surface and segmenting the pelvis and femur from CT data. The Biomechanical Guidance System was used intra-operatively to automatically calculate diagnostic angles and peak-pressure measurements. Manual diagnostic angle measurements were performed based on pre- and postoperative CT. Differences in angle measurements were investigated with summary statistics, intraclass correlation coefficient, and Bland-Altman plots. The percentage postoperative change in peak-pressure was calculated.RESULTS: Intra-operative reported angle measurements show a good agreement with manual angle measurements with intraclass correlation coefficient between 0.94 and 0.98. Computer navigation reported angle measurements were significantly higher for the posterior sector angle ([Formula: see text], [Formula: see text]) and the acetabular anteversion angle ([Formula: see text], [Formula: see text]). No significant difference was found for the center-edge ([Formula: see text]), acetabular index ([Formula: see text]), and anterior sector angle ([Formula: see text]). Peak-pressure after PAO decreased by a mean of 13% and was significantly different ([Formula: see text]).CONCLUSIONS: We found that computer navigation can reliably be used with a minimally invasive transsartorial approach PAO. Angle measurements generally agree with manual measurements and peak-pressure was shown to decrease postoperatively. With further development, the system will become a valuable tool in the operating room for both experienced and less experienced surgeons performing PAO. Further studies with a larger cohort and follow-up will allow us to investigate the association with peak-pressure and postoperative outcome and pave the way to clinical introduction.
AB - BACKGROUND: Periacetabular osteotomy (PAO) is the treatment of choice for younger patients with developmental hip dysplasia. The procedure aims to normalize the joint configuration, reduce the peak-pressure, and delay the development of osteoarthritis. The procedure is technically demanding and no previous study has validated the use of computer navigation with a minimally invasive transsartorial approach.METHODS: Computer-assisted PAO was performed on ten patients. Patients underwent pre- and postoperative computed tomography (CT) scanning with a standardized protocol. Preoperative preparation consisted of outlining the lunate surface and segmenting the pelvis and femur from CT data. The Biomechanical Guidance System was used intra-operatively to automatically calculate diagnostic angles and peak-pressure measurements. Manual diagnostic angle measurements were performed based on pre- and postoperative CT. Differences in angle measurements were investigated with summary statistics, intraclass correlation coefficient, and Bland-Altman plots. The percentage postoperative change in peak-pressure was calculated.RESULTS: Intra-operative reported angle measurements show a good agreement with manual angle measurements with intraclass correlation coefficient between 0.94 and 0.98. Computer navigation reported angle measurements were significantly higher for the posterior sector angle ([Formula: see text], [Formula: see text]) and the acetabular anteversion angle ([Formula: see text], [Formula: see text]). No significant difference was found for the center-edge ([Formula: see text]), acetabular index ([Formula: see text]), and anterior sector angle ([Formula: see text]). Peak-pressure after PAO decreased by a mean of 13% and was significantly different ([Formula: see text]).CONCLUSIONS: We found that computer navigation can reliably be used with a minimally invasive transsartorial approach PAO. Angle measurements generally agree with manual measurements and peak-pressure was shown to decrease postoperatively. With further development, the system will become a valuable tool in the operating room for both experienced and less experienced surgeons performing PAO. Further studies with a larger cohort and follow-up will allow us to investigate the association with peak-pressure and postoperative outcome and pave the way to clinical introduction.
KW - Computer-assisted surgery
KW - Hip dysplasia
KW - Intra-operative angle measurements
KW - Surgical Navigation
UR - http://www.scopus.com/inward/record.url?scp=85048048640&partnerID=8YFLogxK
U2 - 10.1007/s11548-018-1802-y
DO - 10.1007/s11548-018-1802-y
M3 - Journal article
C2 - 29876786
VL - 13
SP - 2021
EP - 2028
JO - International journal of computer assisted radiology and surgery
JF - International journal of computer assisted radiology and surgery
SN - 1861-6410
IS - 12
ER -
ID: 198586763