Биомеханичка анализа троструке остеотомије карлице
Biomechanical analysis of triple pelvic osteotomy
Doktorand
Spasovski, Duško V.Mentor
Vukašinović, ZoranČlanovi komisije
Čobeljić, GoranMainković-Erić, Jelena
Slavković, Slobodan
Metapodaci
Prikaz svih podataka o disertacijiSažetak
Introduction. Hip joint incongruence is found in a number of hip joint
disorders in childhood and adolescence. Altered hip joint compression force
overcomes the adaptive capacity of joint cartilage, inevitably leading to degenerative
joint changes and early invalidity.
Most utilized method for operative treatment of this impairment that we use in
adolescent age is Tennis triple pelvic osteotomy. The effects of operative treatment
can be objectively analyzed by numeric and analytic hip joint mathematical models.
The mathematical model most used in hip joint biomechanical functional analysis is
three-dimensional radiography-based model. It has been widely applied to normal
hips and hips operated by various methods. However, it has not been applied to
Tennis triple pelvic osteotomy.
Goals. To apply three-dimensional radiography-based mathematical model of
the hip joint to standard anterioposterior pelvis and hip radiography, before and after
triple pelvic osteotomy, to calculate parameter...s of contact hip stress distribution
(direction, angle and intensity of resultant hip force, angle and magnitude of peak
contact hip stress, the index of the hip stress gradient), and to analyze the relationship
of biomechanical parameters to patients’ standard clinical and radiographic data.
Material and method. Out of 92 patients with hip joint incongruence in
adolescent age (due to developmental disease of the hip, postreductional avascular
necrosis of femoral head or Leg-Calvé-Perthes disease), operated by Tönnis triple
pelvic osteotomy at the Institute for Orthopaedic Surgery “Banjica” in Belgrade in the
period from 1996. to 2011, 75 hips (60 patients) were included in the test group, with
average Wiberg CE angle of 15,18+/-9,310. All contralateral hips were also analyzed,
and then divided in negative control group (healthy hips, 19 cases) and positive
control group (deformed hips, 56 cases). The three-dimensional radiography-based
mathematical model of the hip joint described by Igli! et al. (1990) was applied to all
the hips, at preoperative, postoperative and final examination. All collected data were
described by standard descriptive statistical tools, and analyzed by appropriate
statistical tests...