Key result
Rotational acetabular osteotomy producing normal femoral head coverage resulted in significantly smaller maximal flexion and internal rotation compared to normal hips in a simulated analysis.
Why the study?
Does simulated rotational acetabular osteotomy with normal femoral head coverage reduce hip range-of-motion compared to normal hips in DDH?
Does simulated rotational acetabular osteotomy with normal femoral head coverage reduce hip range-of-motion compared to normal hips in DDH?
To achieve normal hip range-of-motion after rotational acetabular osteotomy for DDH, target angles providing slightly less than normal coverage may be preferred.
Answers are grounded in this paper and cite their sources.
Targeting normal coverage after RAO may limit flexion and internal rotation; leaves open optimal reorientation targets balancing coverage and ROM.
The optimal reorientation of the acetabulum for developmental dysplasia of the hip (DDH) is unknown in terms of hip range-of-motion (ROM). The simulated ROMs of 52 DDHs after rotational acetabular osteotomy (RAO) with several patterns of femoral head coverage and those of 73 normal hips were analyzed using computer models reconstructed from CT images. After RAO with a lateral center edge angle (LCEA) of 30° and an anterior center edge angle (ACEA) of 55° producing coverage similar to that of normal hips, the maximal flexion and maximal internal rotation at 110° flexion with 20° adduction were significantly smaller than those of the normal group. To achieve ROMs after RAO similar to those of the normal group, an LCEA of 30° with an ACEA of 45°, an LCEA of 25° with an ACEA of 45° to 50°, and an LCEA of 20° with an ACEA of 50° could be preferred angles to target, even though they provided smaller coverage than that of normal hips. After RAO producing femoral head coverage similar to that of normal hips, the maximal flexion and the maximal internal rotation at 110° flexion with 20° adduction were significantly smaller than those of the normal group.
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Hamada et al. (2015) studied Developmental dysplasia of the hip (DDH) (n=125). Rotational acetabular osteotomy (RAO) vs. Normal hips was evaluated on Maximal flexion and maximal internal rotation at 110° flexion with 20° adduction. Rotational acetabular osteotomy producing normal femoral head coverage resulted in significantly smaller maximal flexion and internal rotation compared to normal hips in a simulated analysis.
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