Skip to main content

Evaluation of the three-dimensional bony coverage before and after rotational acetabular osteotomy

International Orthopaedics volume 42, pages 2527–2534 (2018)Cite this article

Abstract

Purpose

Rotational acetabular osteotomy is a type of pelvic osteotomy that involves rotation of the acetabular bone to improve the bony coverage of the femoral head for patients with acetabular dysplasia. Favourable post-operative long-term outcomes have been reported in previous studies. However, there is a paucity of published data regarding three-dimensional bony coverage. The present study investigated the three-dimensional bony coverage of the acetabulum covering the femoral head in hips before and after rotational acetabular osteotomy and in normal hips.

Methods

The computed tomography data of 40 hip joints (12 joints before and after rotational acetabular osteotomy; 16 normal joints) were analyzed. The three-dimensional bony coverage of each joint was evaluated using original software.

Results

The post-operative bony coverage improved significantly compared with pre-operative values. In particular, the anterolateral aspect of the acetabulum tended to be dysplastic in patients with acetabular dysplasia compared to those with normal hip joints. However, greater bony coverage at the anterolateral aspect was obtained after rotational acetabular osteotomy. Meanwhile, the results of the present study may indicate that the bony coverage in the anterior aspect may be excessive.

Conclusion

Three-dimensional analysis indicated that rotational acetabular osteotomy achieved favorable bony coverage. Further investigations are necessary to determine the ideal bony coverage after rotational acetabular osteotomy.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

References

  1. Lane NE, Lin P, Christiansen L, Gore LR, Williams EN, Hochberg MC, Nevitt MC (2000) Association of mild acetabular dysplasia with an increased risk of incident hip osteoarthritis in elderly white women: the study of osteoporotic fractures. Arthritis Rheum 43:400–404

    CAS  Article  Google Scholar 

  2. Rejiman M, Hazes JM, Pols HA, Koes BW, Bierma-Zeinstra SM (2005) Acetabular dysplasia predicts incident osteoarthritis of the hip: the Rotterdam study. Arthritis Rheum 52:787–793

    Article  Google Scholar 

  3. Ninomiya S, Tagawa H (1984) Rotational acetabular osteotomy for the dysplastic hip. J Bone Joint Surg Am 66:127–137

    Article  Google Scholar 

  4. Okano K, Yamada K, Takahashi K, Enomoto H, Osaki M, Shindo H (2010) Joint congruency in abduction before surgery as an indication for rotational acetabular osteotomy in early hip osteoarthritis. Int Orthop 34:27–32

    Article  Google Scholar 

  5. Yasunaga Y, Yamasaki T, Ochi M (2012) Patient selection criteria for periacetabular osteotomy or rotational acetabular osteotomy. Clin Orthop Relat Res 470:3342–3354

    Article  Google Scholar 

  6. Nakamura S, Ninomiya S, Takatori Y, Morimoto S, Umeyama T (1998) Long-term outcome of rotational acetabular osteotomy: 145 hips followed 10-23 years. Acta Orthop Scand 69:259–265

    CAS  Article  Google Scholar 

  7. Takatori Y, Ninomiya S, Nakamura S, Morimoto S, Sasaki T (1996) Long-term follow-up results of rotational acetabular osteotomy in painful dysplastic hips: efficacy in delaying the onset of osteoarthritis. Am J Orthop (Belle Mead NJ) 25:222–225

    CAS  Google Scholar 

  8. 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

    CAS  Article  Google Scholar 

  9. Yasunaga Y, Ochi M, Shimogaki K, Yamamoto S, Iwamori H (2004) Rotational acetabular osteotomy for hip dysplasia: 61 hips followed for 8-15 years. Acta Orthop Scand 75:10–15

    Article  Google Scholar 

  10. Yuasa T, Maezawa K, Kaneko K, Nozawa M (2017) Rotational acetabular osteotomy for acetabular dysplasia and osteoarthritis: a mean follow-up of 20 years. Arch Orthop Trauma Surg 137:465–469

    Article  Google Scholar 

  11. Yasunaga Y, Ochi M, Yamasaki T, Shoji T, Izumi S (2016) Rotational acetabular osteotomy for pre- and early osteoarthritis secondary to dysplasia provides durable results at 20 years. Clin Orthop Relat Res 474:2145–2153

    Article  Google Scholar 

  12. Ito H, Takatori Y, Moro T, Oshima H, Oka H, Tanaka S (2015) Total hip arthroplasty after rotational acetabular osteotomy. J Arthroplast 30:403–406

    Article  Google Scholar 

  13. Yasunaga Y, Iwamori H, Ikuya Y, Yamamoto S, Harada A (1999) Rotational acetabular osteotomy for advanced osteoarthritis secondary to dysplasia of the hip. Results at 6-11 years postoperatively. Arch Orthop Trauma Surg 119:253–257

    CAS  Article  Google Scholar 

  14. Okano K, Enomoto H, Osaki M, Shindo H (2008) Outcome of rotational acetabular osteotomy for early hip osteoarthritis secondary to dysplasia related to femoral head shape: 49 hips followed for 10-17 years. Acta Orthop 79:12–17

    Article  Google Scholar 

  15. Yasunaga Y, Yamasaki T, Matsuo T, Ishikawa M, Adachi N, Ochi M (2010) Crossover sign after rotational acetabular osteotomy for dysplasia of the hip. J Orthop Sci 15:463–469

    Article  Google Scholar 

  16. Nakamura S, Takatori Y, Morimoto S, Umeyama T, Yamamoto M, Toru M, Ninomiya S (1999) Rotational acetabular osteotomy using biodegradable internal fixation. Int Orthop 23:148–149

    CAS  Article  Google Scholar 

  17. Spencer JM, Day RE, Sloan KE, Beaver RJ (2006) Computer navigation of the acetabular component: a cadaver reliability study. J Bone Joint Surg Br 88:972–975

    CAS  Article  Google Scholar 

  18. Li L, Jia J, Zhao Q, Ji S, Wang E (2012) Evaluation of femoral head coverage following Chiari pelvic osteotomy in adolescents by three-dimensional computed tomography and conventional radiography. Arch Orthop Trauma Surg 132:599–605

    Article  Google Scholar 

  19. Liddell AR, Prosser G (2013) Radiographic and clinical analysis if pelvic triple osteotomy for adult hip dysplasia. J Orthop Surg Res 8:17

    Article  Google Scholar 

  20. Jacobsen S, Rømer L, Søballe K (2005) Degeneration in dysplastic hips. A computer tomography study. Skelet Radiol 34:778–784

    Article  Google Scholar 

  21. Ito H, Matsuno T, Hirayama T, Tanino H, Yamanaka Y, Minami (2009) Three-dimensional computed tomography analysis of non-osteoarthritic adult acetabular dysplasia. Skelet Radiol 38:131–139

    Article  Google Scholar 

  22. Iwai S, Kabata T, Maeda T, Kajino Y, Watanabe S, Kuroda K, Fujita K, Hasegawa K, Tsuchiya H (2014) Three-dimensional kinetic simulation before and after rotational acetabular osteotomy. J Orthop Sci 19:443–450

    Article  Google Scholar 

  23. Hamada H, Takao M, Nakahara I, Sakai T, Nishii T, Sugano N (2016) Hip range-of-motion (ROM) is less than normal after rotational acetabular osteotomy for developmental dysplasia of the hip: a simulated ROM analysis. J Orthop Res 34:217–223

    Article  Google Scholar 

  24. Hipp JA, Sugano N, Millis MB, Murphy SB (1999) Planning acetabular redirection osteotomies based on joint contact pressures. Clin Orthop Relat Res 364:134–143

    Article  Google Scholar 

  25. Nakano S, Nishisyo T, Hamada D, Kosaka H, Yutaka K, Oba K, Kawasaki Y, Miyoshi H, Egawa H, Kinoshita I, Yasui N (2008) Treatment of dysplastic osteoarthritis with labral tear by Chiari osteotomy: outcomes after more than 10 years follow-up. Arch Orthop Trauma Surg 128:103–109

    Article  Google Scholar 

  26. Yasunaga Y, Ikuta Y, Kanazawa T, Takahashi K, Hisatome T (2001) The state of the articular cartilage at the time of surgery as an indication for rotational acetabular osteotomy. J Bone Joint Surg Br 83:1001–1004

    CAS  Article  Google Scholar 

  27. Nishii T, Shiomi T, Tanaka H, Yamazaki Y, Murase K, Sugano N (2010) Loaded cartilage T2 mapping in patients with hip dysplasia. Radiology 256:955–965

    Article  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Mr. Takeharu Kato (Halley Valley Co., Ltd.), Dr. Tatsuro Karita, Dr. Hirotaka Chikuda, Dr. Shurei Sugita, and Dr. Shigeyuki Tanaka for their invaluable contributions and participation in this study, and also thank Dr. Kosuke Uehara for his valuable suggestions in preparing the revised manuscript.

Author information

Affiliations

  1. Orthopaedic Surgery, Sensory and Motor System Medicine, Surgical Sciences, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Takeyuki Tanaka, Toru Moro, Hirofumi Oshima & Sakae Tanaka

  2. Division of Science for Joint Reconstruction, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Toru Moro, Yoshio Takatori & Hirofumi Oshima

  3. Bone and Joint Orthopaedic Surgery, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo, 150-8935, Japan

    Hideya Ito

  4. Graduate School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Naohiko Sugita & Mamoru Mitsuishi

Authors
  1. Takeyuki Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Toru Moro
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yoshio Takatori
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hirofumi Oshima
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hideya Ito
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Naohiko Sugita
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Mamoru Mitsuishi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Sakae Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Takeyuki Tanaka.

Ethics declarations

The institutional review board of our hospital granted ethical approval, and informed consent was obtained from all participants before the study commenced.

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Tanaka, T., Moro, T., Takatori, Y. et al. Evaluation of the three-dimensional bony coverage before and after rotational acetabular osteotomy. International Orthopaedics (SICOT) 42, 2527–2534 (2018). https://doi.org/10.1007/s00264-018-3851-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-018-3851-9

Keywords

  • Rotational acetabular osteotomy
  • Bony coverage
  • Three-dimensional evaluation
  • Acetabular dysplasia
  • Morphology of the hip