İbrahim MUTLU, Levent UĞUR, Talip ÇELİK, Arif ÖZKAN, Kaya MEMİŞOĞLU, Yasin KİŞİOĞLU

SALTER PELVİK OSTEOTOMİ AÇISININ KALÇA EKLEMİNDE TEMAS ALANINA VE BASINÇ DAĞILIMINA ETKİLERİ: DENEYSEL ÇALIŞMA

Kalça displazisi femur başı ve asetabulum arasındaki uyumsuzluk olarak tanımlanır. Asetabulum tarafından femur başının yetersiz örtünmesi uyumsuz kalça eklemlerinde displazi oluşumuna yol açar. Kalça ekleminde tedavi amaçlı femur başının örtünme açısının değiştirilmesi ile çeşitli ostetotomiler gerçekleştirilmektedir. Bu çalışmada örtünme açısı üzerine cerrahi uygulamalarda kullanılan osteotomi tekniklerinin etkileri deneysel olarak incelendi. Farklı osteotomi açılarında yapay olarak üretilen hastaya özgü kalçada Salter osteotomi tekniği uygulandı. Kalça ekleminde Fuji Film sensör kullanılarak temas basınç dağılımı ve alanı hesaplandı. Sonuçlar kendi arasında kıyaslandı. Osteotomi örtünme açısı arttıkça ortalama temas basıncı beklendiği gibi azalırken temas alanı beklenmedik şekilde azaldı

Anahtar Kelimeler:

Salter Osteotomisi, Kalça displazisi, Temas Basıncı, Temas Alanı, Örtünme Açısı, Biyomekanik

EFFECTS OF SALTER PELVIC OSTEOTOMY ANGLE ON CONTACT AREA AND PRESSURE DISTRIBUTION IN THE HIP JOINT: AN EXPERIMENTAL STUDY

The hip dysplasia is described by an irregular relation between the femoral head and the acetabulum. Insufficient coverage of the femoral head by the acetabulum leads the development of dysplasia in the incongruity hip joint. Several osteotomies are carried out for treatment by changing with coverage angle of the femoral head in the hip joint. In this paper, the effects of osteotomy techniques used in the surgery applications on the coverage angle are investigated experimentally. Salter osteotomy technique was applied on a patient-specific artificial hip models manufactured at different osteotomy angles. The contact pressure distribution and area were measured by using Fuji Film Prescale sensor in the hip joint. The results were compared with each other. The average contact pressure expectedly decreases as long as osteotomy coverage angle increases but, the contact area decreases unexpectedly

Keywords:

Salter Osteotomy, Hip Dysplasia, Contact Stress, Contact Area, Coverage Angle, Biomechanics,

PDF

___

Afoke, N.,Y., Byers P.D., Hutton W.C., 1987. Contact Pressures in the Human Hip Joint. Journal of Bone Joint and Surgery, British Volume, 69, 536-41.
Böhm, P., Brzuske, A., 2002. Salter Innominate Osteotomy for the Treatment of Developmental Dysplasia of the Hip in Children: Results of Seventy- three Consecutive Osteotomies After Twenty-six to Thirty-five Years of Follow-up. Journal of Bone Joint and Surgery, American Volume, 84, A(2), 178-186.
Hipp, J. A., Sugano, N., Millis, M.B., Murphy, S.B., 1999. Planning Acetabular Redirection Osteotomies Based on Joint Contact Pressures. Clinical Orthopaedics and Related Research. 364, 134-143.
Iglic, A., Iglic, V. K., Daniel, M., Lebar, A. M., 2002. Computer
Distribution and Size of Weight Bearing Area in the Human Hip Joint. Computer Methods in Biomechanics and Biomedical Engineering, 5, 185-192.
Stress Karami, M., Savadkoohi, D. G., Ghadirpoor, A., Rahimpour, S., Azghani, M., Farahmand, F., 2010. A Computer Model for Evaluating the Osteotomy Parameters of Chiari Pelvic Osteotomy. International Orthopaedics, 34, 329-33.
Liggins, A.B., Stranat, J.C.E., Finlay, J. B., Rorabeck., C.H., 1992. Calibration and Manipulation of Data from Fuji Pressure-Sensitive Film. In Experimental Mechanics: Technology Transfer between High Tech Engineering and Biomechanics, Elsevier Science Publishers, Amsterdam.
Mavcic, B., Pompe, B., Daniel, M., Iglic, A., Iglic, V. K., 2002. Mathematical Estimation of Stress Distribution in Normal and Dysplastic Human Hip. Journal of Orthopaedic Research, 20, 1025–1030.
Michaeli, D.A., Murphy, S.B., Hipp J.A., 1997. Comparison of Predicted and Measured Contact Pressures in Normal and Dysplastic Hips. Medical ENgineering and Physics, 19, 180-186.
Mutlu, I., Ugur, L., Celik, T., Buluc, L., Muezzinoglu, U. S., Kisioglu,
Characteristics of a Patient-Specific Artificial Dysplastic Hip Joint. Acta of Bioengineering and Biomechanics, 16, 111-20. of
Contact Pressel, T., Max, S., Pfeifer R., Ostermeier S., Windhagen H., Hurschler C., 2008. A Rapid Prototyping Model for Biomechanical Evaluation of Pelvic Osteotomies. Biomedical Engineering / Biomedizinische Technik, 53, 65-69.
Sparks, D. R., Beason, D.P., Etheridge, B.S., Alonso J.E., Eberhardt A.W., 2005. Contact Pressures in the Flexed Hip Joint During Lateral Trochanteric Loading. Journal of Orthopaedic Research, 23, 359-366.
Sen, C., Demirhan, M., Tuzun, R., Ozger, H., 1996. Polygonal Triple Osteotomy (Kotz's Osteotomy) in the Treatment of Adult Acetabular Dysplasia. Acta Orthopaedica et Traumatologica Turcica, 30, 132-138. Sen, C., 2008. Pelvic Osteotomies in the Treatment of Acetabular Dysplasia: Review. Turkiye Klinikleri Journal of Medical Sciences, 28, 166-177
von Eisenhart-Rothe, R., Witte, H., Steinlechner, M., Müller-Gerbl, M., Putz, R., Eckstein, F., 1999. Quantitative Determination of the Contact Pressure Distribution in the Hip Joint During Gait. Unfallchirurg, 102, 625-31
Tsumura, H., Kaku, N., Ikeda, S., Torisu, T., 2005. A Computer Simulation of Rotational Acetabular Osteotomy for Dysplastic Hip Joint: Does the Optimal Transposition of the Acetabular Fragment Exist? Journal of Orthopaedic Science, 10, 145-151.