Summary: Clinical Paper
The Kingston Periacetabular Osteotomy Utilizing
Computer Enhancement: A New Technique
David J. Mayman, M.D., John Rudan, M.D., F.R.C.S.C., Jeff Yach, M.D., F.R.C.S.C.,
and Randy Ellis, Ph.D.
Departments of Surgery (D.J.M., J.R., J.Y., R.E.) and Computer Science (R.E.), Queen's University,
Kingston, Ontario, Canada
Objective: To develop a new periacetabular osteotomy technique that can be performed
safely and reliably using computer-enhanced technology.
Materials and Methods: This technique uses a modified posterior approach with a trochan-
teric osteotomy. A 3D surface model is generated from CT data. The osteotomy is planned using
custom software developed by our team. A dynamic reference body is fixed to the iliac crest and the
pelvis is registered using an optically tracked probe (Optotrak, Northern Digital, Ontario, Canada).
A tracked probe is used to mark the osteotomies in three dimensions. The posterior column is
osteotomized between the sciatic notch and hip joint. The pubic ramus is osteotomized under
fluoroscopic guidance. The acetabular fragment is rotated into a more appropriate position and fixed
with pelvic reconstruction plates. Subjective and objective data are collected pre- and postopera-
Results: This procedure has been performed on eight patients. Average center-edge angle