Optimization of Acetabulum Reorientation in a Periacetabular Osteotomy by Finite Element Simulation: A Preliminary Study

Periacetabular osteotomy (PAO) is an effective approach for surgical treatment of hip dysplasia in young patients. The aim of PAO is to increase acetabular coverage of the femoral head and to reduce contact pressures by reorienting the acetabulum fragment after PAO. The success of PAO significantly depends on the surgeon’s experience. Previously, we have developed a computer-assisted planning and navigation system for PAO, which allows for not only quantifying the 3D hip morphology with geometric parameters such as acetabular orientation (expressed as inclination and anteversion angles), lateral center edge (LCE) angle, and femoral head coverage for a computer-assisted diagnosis of hip dysplasia but also virtual PAO surgical planning and simulation. In this paper, based on this previously developed PAO planning and navigation system, we developed a patient-specific 3D finite element (FE) model to investigate the optimal acetabulum reorientation after PAO. Our experimental results showed that an optimal position of the acetabulum can be achieved that maximizes contact area and at the same time minimizes peak contact pressure in pelvic and femoral cartilages. In conclusion, our computer-assisted planning and navigation system with FE modeling can be a promising tool to determine the optimal PAO planning strategy.