Finite element analysis evaluation of hypothetical alternative treatment scenarios for neglected developmental dysplasia of the hip




Víctor M. Araujo-Monsalvo, Laboratorio de Biomecánica, Instituto Nacional de Rehabilitación “Luis Guillermo Ibarra Ibarra”; Laboratorio Nacional Conahcyt en Biomecánica del Cuerpo Humano (LNC BiomeCH); Mexico City, Mexico
Marcos Martínez-Cruz, Facultad de Ingeniería, Universidad Nacional Autónoma de México, Mexico City, Mexico
Lázaro Morales-Acosta, Facultad de Ingeniería, Universidad Nacional Autónoma de México, Mexico City, Mexico
Víctor M. Domínguez-Hernández, Laboratorio de Biomecánica, Instituto Nacional de Rehabilitación “Luis Guillermo Ibarra Ibarra”; Laboratorio Nacional Conahcyt en Biomecánica del Cuerpo Humano (LNC BiomeCH); Mexico City, Mexico
Ramiro Cuevas-Olivo, Servicio de Ortopedia Pediátrica, Instituto Nacional de Rehabilitación “Luis Guillermo Ibarra Ibarra”, Mexico City, Mexico
Jesus A. Carrillo-Pelaes, Facultad de Ingeniería, Universidad Nacional Autónoma de México, Mexico City, Mexico
Javier Perez-Orive, Facultad de Ingeniería, Universidad Nacional Autónoma de México;; Servicio de Neurociencias Básicas, Instituto Nacional de Rehabilitación “Luis Guillermo Ibarra Ibarra”; Mexico City, Mexico
Elisa Martínez-Coria, Servicio de Tomografía Computada, Instituto Nacional de Rehabilitación “Luis Guillermo Ibarra Ibarra”, Mexico City, Mexico


Objective: The study aimed to evaluate three different degrees of correction in the surgical treatment of neglected developmental dysplasia of the hip (DDH) using finite element models based on computed tomography. Method: Three tridimensional FEA models of hypothetical post-operative (PO) outcomes were developed, based on three tridimensional CT of a pediatric patient diagnosed with luxated neglected DDH: One with the acetabular index of the contralateral hip (CLAT); another based on a theoretical Bombelli biomechanical model (BMB); and another recreating the patient’s actual PO. Results: The stresses in the affected hip were greater than those in the unaffected hip. CLAT showed the greatest stress and the smallest loading zone (LZ). In contrast, BMB showed the smallest stress and the biggest LZs. Conclusions: The approach based on the BMB gave the best results in terms of the distribution of the stresses over the hip, whereas the worst was CLAT. Qualitatively, estimating the stability and range of movement of the hip, the PO case was considered the best.



Keywords: Neglected developmental dysplasia of the hip. Dega acetabuloplasty. Finite element analysis. Biomechanics.