FP17.2 Concurrent Osteochondroplasty at the Time of Periacetabular Osteotomy does Not Reduce Contact Stress Compared to PAO Alone

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ID: 331380
2026
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Abstract
Abstract ICL17 - The Full Picture: Shaping the Future of Global Hip Preservation, Ground Floor Session Room (BMCC Level 0), October 9, 2026, 14:00 - 16:00 Objectives It remains unclear if osteochondroplasty (OCP) to correct femoral-head neck offset (cam) deformity concurrent with periacetabular osteotomy (PAO) is protective against high contact stresses in addition to preventing persistent femoroacetabular impingement. We hypothesized that concurrent OCP would further reduce joint contact stress when performed with PAO. This was investigated by modeling joint contact stress in PAO-treated dysplastic hips with and without OCP. Methods With IRB approval, we identified 177 dysplastic hips that were treated with a PAO and concurrent osteochondroplasty for which both pre and postoperative CT scans were available. Patient-specific discrete element analysis models were developed from clinical preoperative and postoperative CT scans of each hip to calculate joint contact stress, contact stress exposure (patient age times contact stress), and contact area during a standardized walking gait. For each hip, a preoperative model and a postoperative model (PAO+OCP) were generated. A third model was generated from each hip using the postoperative acetabular fragment reorientation and the preoperative femur model with the head-neck offset deformity still present. This model represented the hip if only the PAO had been done (PAO alone). Statistical comparisons between preoperative, simulated PAO alone, and postoperative (combined PAO+OCP) models were performed using repeated measures ANOVA and Tukey’s pairwise comparisons (GraphPad Prism v11.0). Statistical significance was defined as p < 0.05. Results Postoperative (PAO+OCP) peak and mean contact stress was significantly lower than preoperative values (14.2 MPa vs 15.2 MPa, p<0.0001; 3.22 MPa vs 3.38 MPa, p=0.0007 for peak and mean, respectively). Contact area was also significantly larger (p=0.011) postoperatively (691 mm2) compared to preoperatively (668 mm2). There were zero differences in the computed contact stress or contact patch location between the actual postoperative (PAO+OCP) and simulated PAO-alone conditions among any of the 177 hips modeled. Conclusion Femoral head-neck offset correction for femoroacetabular impingement in patients with hip dysplasia minimally affects DEA-computed joint contact mechanics during walking compared to periacetabular osteotomy alone. Future work will model squat and stair ascent to determine if OCP results in improved mechanics after PAO during activities that require greater hip flexion.
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Authors Dominic J. L. Rivas, Michael Willey, Wyatt M. Sailer, Ashley Kochuyt, Holly Aitken, Robert W. Westermann, John Clohisy, Jessica E. Goetz
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.130
URL
https://doi.org/10.1093/jhps/hnag043.130
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