Preoperative Planning for Eccentric Rotational Acetabular Osteotomy

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  • MORITA Yuji
    Department of Orthopaedic Surgery, Tokyo Women's Medical University
  • OTSURU Tadahiko
    Department of Orthopaedic Surgery, Tokyo Women's Medical University
  • MUNAKATA Yutarou
    Department of Orthopaedic Surgery, Tokyo Women's Medical University
  • KATO Yosiharu
    Department of Orthopaedic Surgery, Tokyo Women's Medical University
  • HASEGAWA Yukiharu
    Department of Orthopaedic Surgery, Nagoya University School of Medicine

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Background and Design: Eccentric rotational acetabular osteotomy (ERAO), allows for the consistent achievement of the desired displacement of the femoral head. To our knowledge, a method of preoperative planning for this procedure has not been reported. We propose two methods of preoperative planning based on the assumption that all points inside the osteotomy circle rotate θ degrees around the center of this circle when the acetabulum is rotated θ degrees around the center. The objectives of this study were to confirm the above assumption and to examine the appropriate radius of curvature for the osteotome used during ERAO.<br>Methods: In July 2012, ERAO was performed on four patients with acetabular dysplasia based on the surgeon's planning diagram. The horizontal and vertical distances between the preoperative and postoperative centers of the femoral head were measured on the surgeon's planning diagram, on our planning diagram obtained with the first method, and on radiographs, respectively. We also performed preoperative planning by our second method. The radius of curvature of the osteotome was then measured from our preoperative planning data.<br>Results: The horizontal and vertical distances on our diagrams corresponded closely to the distances on the radiographs. In contrast, the horizontal distances on the surgeon's diagrams were larger than those on the radiographs. The radius of curvature of the osteotome was 37, 32, 32, and 41 millimeters (mm) in case 1, 2, 3, and 4, respectively.<br>Conclusion: The present study demonstrated that the horizontal distance and the vertical distance on our planning diagrams corresponded closely to the distances on the radiographs, suggesting that our assumption was verified. Our two methods of preoperative planning are both suitable for ERAO. Finally, an osteotome with a radius of curvature less than 50 mm is appropriate for ERAO.

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