The Kingston periacetabular osteotomy utilizing computer enhancement: a new technique.

Abstract

To develop a new periacetabular osteotomy technique that can be performed safely and reliably using computer-enhanced technology. This technique uses a modified posterior approach with a trochanteric osteotomy. A 3D surface model is generated from CT data. The osteotomy is planned using custom software developed by our team. A dynamic reference body is fixed to the iliac crest and the pelvis is registered using an optically tracked probe (Optotrak, Northern Digital, Ontario, Canada). A tracked probe is used to mark the osteotomies in three dimensions. The posterior column is osteotomized between the sciatic notch and hip joint. The pubic ramus is osteotomized under fluoroscopic guidance. The acetabular fragment is rotated into a more appropriate position and fixed with pelvic reconstruction plates. Subjective and objective data are collected pre- and postoperatively. This procedure has been performed on eight patients. Average center-edge angle correction has been 17 degrees. The computer and optical guidance system has provided accurate information in seven of eight cases, and there have been no complications. This technique has enabled us to perform periacetabular osteotomies with safety and predictability. Using this computer-enhanced technique, periacetabular osteotomy may become a more common procedure in the practice of hip reconstruction surgeons.