Computer-Assisted Planning, Simulation, and Navigation System for Periacetabular Osteotomy

  • Li LiuEmail author
  • Klaus Siebenrock
  • Lutz-P. Nolte
  • Guoyan Zheng
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 1093)


Periacetabular osteotomy (PAO) is an effective approach for surgical treatment of hip dysplasia in young adults. However, achieving an optimal acetabular reorientation during PAO is the most critical and challenging step. Routinely, the correct positioning of the acetabular fragment largely depends on the surgeon’s experience and is done under fluoroscopy to provide the surgeon with continuous live x-ray guidance. Our developed system starts with a fully automatic detection of the acetabular rim, which allows for quantifying the acetabular 3D morphology with parameters such as acetabular orientation, femoral head extrusion index (EI), lateral center-edge (LCE) angle, and total and regional femoral head coverage (FHC) ratio for computer-assisted diagnosis, planning, and simulation of PAO. Intraoperative navigation is conducted to implement the preoperative plan. Two validation studies were conducted on four sawbone models to evaluate the efficacy of the system intraoperatively and postoperatively. By comparing the preoperatively planned situation with the intraoperatively achieved situation, average errors of 0.6° ± 0.3°, 0.3° ± 0.2°, and 1.1° ± 1.1° were found, respectively, along three motion directions (flexion/extension, abduction/adduction, and external rotation/internal rotation). In addition, by comparing the preoperatively planned situation with the postoperative results, average errors of 0.9° ± 0.3° and 0.9° ± 0.7° were found for inclination and anteversion, respectively.


Hip dysplasia Periacetabular osteotomy (PAO) Planning Simulation Navigation Image-guided surgery Joint preservation surgery 



This work is supported in part by Natural Science Foundation of SZU (grant no. 2017089). This chapter was modified from the paper published by our group in The 7th International Conference on Medical Imaging and Augmented Reality (MIAR2016) (Li et al., MIAR2016; 15-26). The related contents were reused with permission.


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Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • Li Liu
    • 1
    • 2
    Email author
  • Klaus Siebenrock
    • 3
  • Lutz-P. Nolte
    • 2
  • Guoyan Zheng
    • 2
  1. 1.National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Health Science CenterShenzhen UniversityShenzhenChina
  2. 2.Institute for Surgical Technology and BiomechanicsUniversity of BernBernSwitzerland
  3. 3.Department of Orthopedic Surgery, InselspitalUniversity of BernBernSwitzerland

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