The objective of the proposed research is to assess the feasibility of integrating near real-time biomechanics with CT-guided navigation for intraoperative decision-making during joint osteotomies. An intraoperative biomechanical guidance system (BGS) will be developed and tested. The system will be used by the surgeon during periacetabular osteotomies. The BGS will interact with the surgeon during the operation and obtain the current biomechanical state of the joint. It will use the information from the imagery of a computer-assisted navigation system and display the contact pressure distribution in the hip joint as the joint realignment is modified intraoperatively. In order to test the functionality and reliability of the BGS, the periacetabular osteotomy operation with biomechanical guidance will be performed on cadavers. Based on the available conventional techniques, minimum anatomical criteria for successful joint alignment during periacetabular surgery will be identified. The reliability of the system will be determined by testing whether the system continuously satisfies those criteria for joint realignment. Conventional periacetabular osteotomy techniques realign the anatomical angles of the dysplastic hip to that of the normal hip. In order to compare the clinical outcomes of the Periacetabular osteotomy with near real-time BGS to that of conventional techniques, 6-month clinical and radiological follow-ups will be performed and the clinical outcomes will be compared. While the focus of this work will be on periacetabular osteotomy, applications of this research can be extended to other types of hip osteotomies, joint osteotomies, and total joint replacement techniques.
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