Skip to main content

Advertisement

Log in

Variations in the obturator artery around the obturator foramen assessed by three-dimensional computed tomographic angiography and prevention of vascular-related complications in rotational acetabular osteotomy

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

The aims of this study were (1) to evaluate the anatomical variations and locations of the obturator artery at the obturator foramen using computed tomographic (CT) angiography images and (2) to evaluate the pubic osteotomy site in rotational acetabular osteotomy using postoperative CT images in order to assess the relationship between the obturator artery and the pubic osteotomy site.

Methods

We examined a total of 196 hips in 98 consecutive Japanese patients for aim (1), and 38 consecutive patients who underwent rotational acetabular osteotomy for aim (2).

Results

The prevalence of arterial anastomosis of the obturator artery (corona mortis) was 14.3 %, with the obturator artery being located closer to the superior pubic ramus and the osteotomy site in these subjects.

Conclusions

Extensive care should be taken during rotational acetabular osteotomy in patients showing variations of the obturator artery with corona mortis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Clohisy JC, Schutz AL, St John L, Schoenecker PL, Wright RW (2009) Periacetabular osteotomy: a systematic literature review. Clin Orthop Relat Res 467:2041–2052. doi:10.1007/s11999-009-0842-6

    Article  PubMed  PubMed Central  Google Scholar 

  2. Yasunaga Y, Yamasaki T, Ochi M (2012) Patient selection criteria for periacetabular osteotomy or rotational acetabular osteotomy. Clin Orthop Relat Res 470:3342–3354. doi:10.1007/s11999-012-2516-z

    Article  PubMed  PubMed Central  Google Scholar 

  3. Siebenrock KA, Schaller C, Tannast M, Keel M, Büchler L (2014) Anteverting periacetabular osteotomy for symptomatic acetabular retroversion: results at ten years. J Bone Joint Surg Am 96:1785–1792. doi:10.2106/JBJS.M.00842

    Article  PubMed  Google Scholar 

  4. Jingushi S, Ohfuji S, Sofue M et al (2010) Multiinstitutional epidemiological study regarding osteoarthritis of the hip in Japan. J Orthop Sci 15:626–631. doi:10.1007/s00776-010-1507-8

    Article  PubMed  Google Scholar 

  5. Jingushi S, Ohfuji S, Sofue M et al (2011) Osteoarthritis hip joints in Japan: involvement of acetabular dysplasia. J Orthop Sci 16:156–164. doi:10.1007/s00776-011-0025-7

    Article  PubMed  Google Scholar 

  6. Ninomiya S, Tagawa H (1984) Rotational acetabular osteotomy for the dysplastic hip. J Bone Joint Surg Am 66:430–436

    Article  CAS  PubMed  Google Scholar 

  7. Takatori Y, Ninomiya S, Nakamura S, Morimoto S, Moro T, Nagai I, Mabuchi A (2001) Long-term results of rotational acetabular osteotomy in patients with slight narrowing of the joint space on preoperative radiographic findings. J Orthop Sci 6:137–140. doi:10.1007/s0077610060137

    Article  CAS  PubMed  Google Scholar 

  8. Ito H, Tanino H, Yamanaka Y, Minami A, Matsuno T (2011) Intermediate to long-term results of periacetabular osteotomy in patients younger and older than forty years of age. J Bone Joint Surg Am 93:1347–1354. doi:10.2106/JBJS.J.01059

    Article  PubMed  Google Scholar 

  9. Kaneuji A, Sugimori T, Ichiseki T, Fukui K, Takahashi E, Matsumoto T (2015) Rotational acetabular osteotomy for osteoarthritis with acetabular dysplasia: conversion rate to total hip arthroplasty within twenty years and osteoarthritis progression after a minimum of twenty years. J Bone Joint Surg Am 97:726–732. doi:10.2106/JBJS.N.00667

    Article  PubMed  Google Scholar 

  10. Hasegawa Y, Iwase T, Kitamura S, Yamauchi Ki K, Sakano S, Iwata H (2002) Eccentric rotational acetabular osteotomy for acetabular dysplasia: follow-up of one hundred and thirty-two hips for five to ten years. J Bone Joint Surg Am 84-A:404–410

    Article  PubMed  Google Scholar 

  11. Davey JP, Santore RF (1999) Complications of periacetabular osteotomy. Clin Orthop Relat Res 33-37

  12. Matta JM, Stover MD, Siebenrock K (1999) Periacetabular osteotomy through the Smith-Petersen approach. Clin Orthop Relat Res 21–32

  13. Brenøe A-S, Andersen PE, Overgaard S (2006) Endovascular embolisation of severe bleeding in connection with periacetabular osteotomy. Ugeskr Laeg 168:1453–1454

    PubMed  Google Scholar 

  14. Thawrani D, Sucato DJ, Podeszwa DA, DeLaRocha A (2010) Complications associated with the Bernese periacetabular osteotomy for hip dysplasia in adolescents. J Bone Joint Surg Am 92:1707–1714. doi:10.2106/JBJS.I.00829

    Article  PubMed  Google Scholar 

  15. Tornetta P, Hochwald N, Levine R (1996) Corona mortis. Incidence and location. Clin Orthop Relat Res 97–101

  16. Gilroy AM, Hermey DC, DiBenedetto LM, Marks SC Jr, Page DW, Lei QF (1997) Variability of the obturator vessels. Clin Anat 10:328–332. doi:10.1002/(SICI)1098-2353(1997)10:5<328::AID-CA7>3.0.CO;2-M

    Article  CAS  PubMed  Google Scholar 

  17. Smith JC, Gregorius JC, Breazeale BH, Watkins GE (2009) The corona mortis, a frequent vascular variant susceptible to blunt pelvic trauma: identification at routine multidetector CT. J Vasc Interv Radiol 20:455–460. doi:10.1016/j.jvir.2009.01.007

    Article  PubMed  Google Scholar 

  18. Karakurt L, Karaca I, Yilmaz E, Burma O, Serin E (2002) Corona mortis: incidence and location. Arch Orthop Trauma Surg 122:163–164. doi:10.1007/s004020100341

    Article  PubMed  Google Scholar 

  19. Okcu G, Erkan S, Yercan HS, Ozic U (2004) The incidence and location of corona mortis: a study on 75 cadavers. Acta Orthop Scand 75:53–55. doi:10.1080/00016470410001708100

    Article  PubMed  Google Scholar 

  20. Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174

    Article  CAS  PubMed  Google Scholar 

  21. Naito M, Nakamura Y (2014) Curved periacetabular osteotomy for the treatment of dysplastic hips. Clin Orthop Surg 6:127–137. doi:10.4055/cios.2014.6.2.127

    Article  PubMed  PubMed Central  Google Scholar 

  22. Kinoshita K, Naito M, Shiramizu K, Kamada S (2011) Prevention of obturator artery injury during pubic osteotomy in periacetabular osteotomy. Curr Orthop Pract 22(2):171–175

    Article  Google Scholar 

  23. Kamada S, Naito M, Shiramizu K, Nakamura Y, Kinoshita K (2011) Is the obturator artery safe when performing ischial osteotomy during periacetabular osteotomy? Int Orthop 35:503–506. doi:10.1007/s00264-010-1064-y

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tomohiro Goto.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wada, K., Goto, T., Tezuka, F. et al. Variations in the obturator artery around the obturator foramen assessed by three-dimensional computed tomographic angiography and prevention of vascular-related complications in rotational acetabular osteotomy. International Orthopaedics (SICOT) 41, 133–139 (2017). https://doi.org/10.1007/s00264-016-3268-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-016-3268-2

Keywords

Navigation