Finite element modeling for biomechanical validation of three-dimensional digital surgical planning in periacetabular osteotomy

The periacetabular osteotomy (PAO) is recognized as an effective treatment of symptomatic patients with developmental dysplasia of the hip (DDH) without osteoarthritis. In this work, it is proposed to validate a digital planning performed by a surgeon for a real patient with DDH by finite element modeling taking into account a realistic geometry of anatomy, considering the degrees of freedom and angular amplitudes associated with the six joint movements: flexion ( 0^∘ – 120^∘ ); extension ( 0^∘ – 20^∘ ); abduction ( 0^∘ – 40^∘ ); adduction (0 ^∘ –25 ^∘ ); external rotation ( 0^∘ – 45^∘ ); and internal rotation ( 0^∘ – 35^∘ ). A comparison between the preoperative and planned models for all scenarios was made. A Python script gets the biomechanical model for orthostatic position, rotates femur in angle increments and creates and submits a job. If one job has been completed, a next job starts for the following increment of femur rotation. If one job has not been completed, it is considered the movement limit. In all evaluated scenarios, it was observed a reduction in contact pressure from preoperative model to postoperative model (approximately 61.24