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

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.