Effects of Curved Periacetabular Osteotomy on the Stress Fields
of the Pubic Rami and Ischium: A Finite Element Model Analysis
Copyright © 2013 SciRes. OJO
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period of time. For a patient with discontinuity at the
osteotomy site, we suggest that weight bearing in the
operative side be delayed, and we especially recommend
non-weight bearing on the operative side. Moreover, we
also recommend that patients avoid the sitting position
for as long as possible, and take care to sit down slowly.
A limitation of this study is the examination of the
only one pelvic model. The load distribution may be dif-
ferent from other pelvic models because of variation in
pelvic morphology, especially in the width of the infe-
rior pubic rami or in bone mineral density. Moreover, the
discontinuity model in this current study was recon-
structed by virtual deletion and not by using an actual CT
scan from a patient before healing of superior pubic rami.
However, if the model was used before healing of supe-
rior pubic rami, other osteotomy sites, such as ilium
around the acetabulum will not join, therefore, the dis-
tribution may be different. Furthermore, the deletion
width in this study was defined as 5 mm, but the actual
width will be irregular. Therefore, the stress locations or
value may be affected by the deletion width. However,
the location of the stress field was similar to that in our
previous study [10] in a different pelvic model; therefore,
the results of this current study are valid at least with
regard to the stress field. Furthermore, in this study, we
applied a force of 174 N from most distal point of each
bilateral ischium in the sitting model. There are many
muscles and soft tissues around the buttocks, so the load
distribution of the inferior pubic rami and ischium may
be smaller in actuality.
In conclusion, we demonstrated that discontinuity at
the osteotomy site of the superior pubic rami increased
the load on the inferior pubic rami and ischium on the
osteotomy side. Surgeons should be aware of the fact that
these fractures are complications that occur at a relatively
early stage after acetabular osteotomies, including CPO.
Furthermore, we recommend that weight bearing on the
operative side be delayed, and that patients avoid the
sitting position for as long as possible, taking care to sit
down slowly to prevent inferior pubic rami and ischial
fractures after acetabular osteotomies.
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