Impact of triple pelvic osteotomy on contact stress pressure distribution in the hip joint |
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Authors: | Zoran Vukasinovic Dusko Spasovski Veronika Kralj-Iglic Jelena Marinkovic-Eric Igor Seslija Zorica Zivkovic Vesna Spasovski |
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Affiliation: | 1. University of Belgrade, Faculty of Medicine, Institute for Orthopaedic Surgery “Banjica”, Belgrade, Serbia 2. University of Ljubljana, Faculty of Health Sciences, Biomedical Research Group, Ljubljana, Slovenia 3. University of Belgrade, Faculty of Medicine, Institute for Medical Statistics and Informatics, Belgrade, Serbia 4. Institute for Orthopaedic Surgery “Banjica”, Belgrade, Serbia 5. European University, Medical Academy “US Medical School”, Medical Center “Dr Dragisa Misovic”, Belgrade, Serbia 6. University of Belgrade, Institute of Molecular Genetics and Genetic Engineering, Belgrade, Serbia
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Abstract: | PurposeWe studied changes of contact stress distribution in the hip joint after Tonnis triple pelvic osteotomy applied in the treatment of dysplasia and hip joint incongruence in adolescents.MethodsIn a group of 75 patients, 54 (72 %) female, who underwent surgery by triple pelvic osteotomy in adolescence for developmental disorder of the hip and avascular necrosis of the femoral head, a three-dimensional hip joint model was used based on the radiography of the pelvis with hips. The following biomechanical parameters were calculated: resultant hip force normalised to body weight (R/Wb), inclination of the resultant hip force (θ−R), the position of the stress pole (θ), peak contact hip stress (Pmax), and peak contact hip stress normalised to body weight (Pmax/Wb). Gait quality was also assessed.ResultsAfter surgery the Wiberg CE angle was increased by 17.85° (114 %), resultant hip force normalised to body weight (R/Wb) was decreased by 0.107 (3.3 %), the position of the stress pole was shifted medially by 27.59° (63.5 %), and peak contact hip stress normalised to body weight (Pmax/Wb) was decreased by 2249.74 (55.9 %). Waddling gait was reduced from 17 (23.9 %) to four cases (5.6 %). All changes were statistically highly significant (p<0.01).ConclusionsThe effect of Tonnis triple pelvic osteotomy lies in the improvement of stress distribution across the acetabular cartilage of the hip joint, thus slowing down the degenerative damage of the hip joint. |
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