Introduction: Our ongoing effort has been to develop a software suite that allows a clinician to surgically plan and execute a periacetabular osteotomy with feedback reflecting both the internal joint stress state during activities of daily living and computer-simulated radiological information. This Biomechanical Guidance System (BGS) allows the clinician to graphically load CT scan data and characterize a patient's malformed dysplastic hip using conventional radiological angle measurements, as well as biomechanical methods. Using a navigation system intraoperatively, the biomechanical model is updated in real-time to reflect improved stress distribution within the hip joint during re-alignment. We have previously presented our preliminary systems validation of the BGS in laboratory testing on surrogate bones and simulation of the procedure on cadaveric specimen (Armand et al., 2006). Laboratory testing showed that the biomechanical contact pressure calculations were feasible in real-time, and hardware accuracy was confirmed. This work reports our first ten clinical experiences using the BGS system (JHM IRB1 #05-09-02-01).
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