Skip to main content

Advertisement

SpringerLink
Log in

Developing a novel custom cutting guide for curved peri-acetabular osteotomy

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

Abstract

Purpose

Curved peri-acetabular osteotomy (CPO) produces excellent clinical results, but the surgical procedure is technically demanding, and severe complications related to the osteotomy have been reported. To provide a safe, accurate surgical procedure, we have developed a novel method for setting the cutting line and direction. We have designed and made a custom cutting guide for individual patients. The purpose of the study was to evaluate the efficacy of this new method and cutting guide.

Methods

The cutting line was designed on a full-scale three-dimensional plaster model made from computed tomography (CT) data for each case. The surface of each plaster model was colour-coded according to the distance from the centre of the femoral head. A custom cutting guide was designed based on this cutting line on the workstation. A titanium custom cutting guide was fabricated using rapid prototyping technology. The cutting guide directed the cutting direction of the osteotome. We evaluated the outcomes for seven consecutive hips in seven patients who underwent CPO using the system between April and December 2011. All peri-operative complications were recorded. The accuracy of the cutting line was evaluated using CT data obtained two weeks after the operation.

Results

There were no major complications related to the osteotomy such as posterior column fracture or intra-articular osteotomy. The actual cutting line corresponded almost exactly to the planned cutting line in all cases.

Conclusions

The colour-coded plaster model and the custom cutting guide were effective for avoiding severe complications associated with a CPO.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

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

Similar content being viewed by others

References

  1. Murphy SB, Ganz R, Müller ME (1995) The prognosis in untreated dysplasia of the hip. A study of radiographic factors that predict the outcome. J Bone Joint Surg Am 77(7):985–989

    PubMed  CAS  Google Scholar 

  2. Poss R (1984) The role of osteotomy in the treatment of osteoarthritis of the hip. J Bone Joint Surg Am 66(1):144–151

    PubMed  CAS  Google Scholar 

  3. Wagner H (1976) Osteotomy for congenital hip dislocation. In: Proceedings of the fourth scientific meeting of the Hip Society. Mosby, St. Louis, pp 45–66

  4. Eppright RH (1975) Dial osteotomy of the acetabulum in the treatment of dysplasia of the hip. J Bone Joint Surg Am 57(8):1172

    Google Scholar 

  5. Ninomiya S, Tagawa H (1984) Rotational acetabular osteotomy for the dysplastic hip. J Bone Joint Surg Am 66(3):430–436

    PubMed  CAS  Google Scholar 

  6. Ko JY, Wang CJ, Lin CF, Shih CH (2002) Periacetabular osteotomy through a modified ollier transtrochanteric approach for treatment of painful dysplastic hips. J Bone Joint Surg Am 84-A(9):1594–1604

    PubMed  Google Scholar 

  7. Nozawa M, Shitoto K, Matsuda K, Maezawa K, Kurosawa H (2002) Rotational acetabular osteotomy for acetabular dysplasia. A follow-up for more than ten years. J Bone Joint Surg Br 84(1):59–65

    Article  PubMed  Google Scholar 

  8. Ito H, Matsuno T, Minami A (2007) Rotational acetabular osteotomy through an ollier lateral u approach. Clin Orthop Relat Res 459:200–206. doi:10.1097/BLO.0b013e31803b942a

    Article  PubMed  Google Scholar 

  9. Hussell JG, Mast JW, Mayo KA, Howie DW, Ganz R (1999) A comparison of different surgical approaches for the periacetabular osteotomy. Clin Orthop Relat Res 363:64–72

    PubMed  Google Scholar 

  10. Ganz R, Klaue K, Vinh TS, Mast JW (1988) A new periacetabular osteotomy for the treatment of hip dysplasias. Technique and preliminary results. Clin Orthop Relat Res 232:26–36

    PubMed  Google Scholar 

  11. Steppacher SD, Tannast M, Ganz R, Siebenrock KA (2008) Mean 20-year followup of Bernese periacetabular osteotomy. Clin Orthop Relat Res 466(7):1633–1644. doi:10.1007/s11999-008-0242-3

    Article  PubMed  Google Scholar 

  12. Matheney T, Kim YJ, Zurakowski D, Matero C, Millis M (2010) Intermediate to long-term results following the bernese periacetabular osteotomy and predictors of clinical outcome: surgical technique. J Bone Joint Surg Am 92(Suppl 1 Pt 2):115–129. doi:10.2106/JBJS.J.00646

    PubMed  Google Scholar 

  13. Hartig-Andreasen C, Troelsen A, Thillemann TM, Søballe K (2012) What factors predict failure 4 to 12 years after periacetabular osteotomy? Clin Orthop Relat Res 470(11):2978–2987. doi:10.1007/s11999-012-2386-4

    Article  PubMed  Google Scholar 

  14. Zhu J, Chen X, Cui Y, Shen C, Cai G (2013) Mid-term results of Bernese periacetabular osteotomy for developmental dysplasia of hip in middle aged patients. Int Orthop. doi:10.1007/s00264-013-1790-z

    Google Scholar 

  15. Shiramizu K, Naito M, Asayama I, Yatsunami M (2003) Curved periacetabular osteotomy for the dysplastic hip: cadaveric and radiological analyses of safe procedures. J Orthop Traumatol 4:55–60

    Google Scholar 

  16. Naito M, Shiramizu K, Akiyoshi Y, Ezoe M, Nakamura Y (2005) Curved periacetabular osteotomy for treatment of dysplastic hip. Clin Orthop Relat Res 433:129–135

    Article  PubMed  Google Scholar 

  17. Hussell JG, Rodriguez JA, Ganz R (1999) Technical complications of the Bernese periacetabular osteotomy. Clin Orthop Relat Res 363:81–92

    PubMed  Google Scholar 

  18. Davey JP, Santore RF (1999) Complications of periacetabular osteotomy. Clin Orthop Relat Res 363:33–37

    Article  PubMed  Google Scholar 

  19. Akiyama H, Goto K, So K, Nakamura T (2010) Computed tomography-based navigation for curved periacetabular osteotomy. J Orthop Sci 15(6):829–833

    Article  PubMed  Google Scholar 

  20. Hsieh PH, Chang YH, Shih CH (2006) Image-guided periacetabular osteotomy: computer-assisted navigation compared with the conventional technique: a randomized study of 36 patients followed for 2 years. Acta Orthop 77(4):591–597. doi:10.1080/17453670610012656

    Article  PubMed  Google Scholar 

  21. Crowe JF, Mani VJ, Ranawat CS (1979) Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am 61(1):15–23

    PubMed  CAS  Google Scholar 

  22. Tönnis D, Heinecke A (1999) Acetabular and femoral anteversion: relationship with osteoarthritis of the hip. J Bone Joint Surg Am 81(12):1747–1770

    PubMed  Google Scholar 

  23. Ezoe M, Naito M, Asayama I (2006) Muscle strength improves after abductor-sparing periacetabular osteotomy. Clin Orthop Relat Res 444:161–168

    Article  PubMed  Google Scholar 

  24. Shiramizu K, Naito M, Asayama I, Yatsunami M (2004) A quantitative anatomic characterization of the quadrilateral surface for periacetabular osteotomy. Clin Orthop Relat Res 418:157–161

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan

    Bungo Otsuki, Keiichi Kawanabe & Yasunari Awa

  2. Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Kyoto, Japan

    Bungo Otsuki, Mitsuru Takemoto, Haruhiko Akiyama, Shunsuke Fujibayashi & Shuichi Matsuda

  3. Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Kyoto, Japan

    Takashi Nakamura

Authors
  1. Bungo Otsuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mitsuru Takemoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Keiichi Kawanabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yasunari Awa
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Haruhiko Akiyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shunsuke Fujibayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Takashi Nakamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Shuichi Matsuda
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bungo Otsuki.

Additional information

Bungo Otsuki and Mitsuru Takemoto contributed equally to this work.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Otsuki, B., Takemoto, M., Kawanabe, K. et al. Developing a novel custom cutting guide for curved peri-acetabular osteotomy. International Orthopaedics (SICOT) 37, 1033–1038 (2013). https://doi.org/10.1007/s00264-013-1873-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-013-1873-x

Keywords

Search

Navigation