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Comparison of rotational acetabular osteotomy performed with navigation by surgeons with different levels of experience of osteotomies

International Journal of Computer Assisted Radiology and Surgery volume 12, pages 841–853 (2017)Cite this article

Abstract

Purpose

Rotational acetabular osteotomy (RAO) is used to treat developmental hip dysplasia (DDH). It requires detailed anatomical knowledge of the pelvic anatomy and three-dimensional cognitive skills. We addressed whether a computer navigation system combined with a preoperative computed tomography-based plan enabled surgeons to perform RAO safely and reliably through a mini-incision regardless of their level of experience with performing osteotomies.

Methods

We enrolled 24 patients (25 hips) with DDH (radiographic grade 0 or 1 osteoarthritic changes: Tönnis classification). Using the navigation system, four surgeons performed RAO via a mini-incision transtrochanteric approach. Two experienced surgeons treated 15 patients (16 hips). Two surgeons with low-level RAO experience treated nine patients (9 hips). Operative data and clinical and radiographic outcomes were compared. Average follow-up was 3.2 years.

Results

There were no significant differences in the (1) incision length, operation time, or intraoperative blood loss; (2) numerical pain rating scale score and Western Ontario and McMaster Universities Osteoarthritis Index Scale score at 1, 2 years, and at the latest follow-up; (3) preoperative and postoperative acetabular coverage of the femoral head, postoperative joint congruency, postoperative medial and distal femoral head displacement, or acetabular thickness; and (4) positional accuracy of iliac, pubic, and ischial osteotomy and accuracy of acetabular coverage of the femoral head.

Conclusions

Clinical and radiographic outcomes of RAO with navigation were not influenced by the surgeons’ level of osteotomy experience.

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Acknowledgments

We thank Prof. Hideki Yoshikawa and Dr. Nobuo Nakamura for their scientific advice and many insightful discussions. We did not receive any funding related this study.

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Affiliations

  1. Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Masaki Takao, Takashi Nishii & Nobuhiko Sugano

  2. Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Takashi Sakai

Authors
  1. Masaki Takao
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  2. Takashi Nishii
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  3. Takashi Sakai
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  4. Nobuhiko Sugano
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Correspondence to Masaki Takao.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Takao, M., Nishii, T., Sakai, T. et al. Comparison of rotational acetabular osteotomy performed with navigation by surgeons with different levels of experience of osteotomies. Int J CARS 12, 841–853 (2017). https://doi.org/10.1007/s11548-016-1494-0

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Keywords

  • Navigation
  • Rotational acetabular osteotomy
  • Developmental hip dysplasia
  • Surgical experience
  • Computed tomography