Curved periacetabular osteotomy using intraoperative real-time 3-dimensional computed tomography with a robotic C-arm system

Abstract

RATIONALE: Curved periacetabular osteotomy (CPO) is a procedure with excellent surgical outcome that has been proposed for patients with development dysplasia of the hip (DDH). However, the surgical outcomes depend on the surgeon's experience and proficiency. PATIENT CONCERNS: A 38-year-old female indicated she was experiencing left hip pain while walking. DIAGNOSES: The patient was diagnosed with early-stage hip osteoarthritis due to DDH. INTERVENTIONS: The patient underwent CPO while a 3-dimensional flat-panel C-arm (Artis zeego; Sciemens Healthcare, Forchheim, Germany) was used to confirm the real-time 3-dimensional computed tomography (CT) images during surgery. It was possible to confirm the accurate osteotomy curve using CT images twice during surgery: at the time of the ischial osteotomy and the quadrilateral surface osteotomy. OUTCOMES: An ideal C-shaped osteotomy line was created as shown on the postoperative CT images. In addition, neither posterior column fracture nor intra-articular osteotomy was confirmed. LESSONS: The CPO using Artis zeego resulted is a satisfactory outcome, and this is the 1st report in the world to discuss the benefits of Artis zeego in pelvic osteotomy.