Effect of improved navigation performance on the accuracy of implant placement in total hip arthroplasty with a CT-based navigation system

Background: Accelerometer-based portable navigation systems in supine total hip arthroplasty (THA) have been developed, but there are no reports on the accuracy of cup placement. We aimed to investigate and compare the accuracy of the accelerometer-based portable navigation system versus the acetabular alignment guide placed on the pelvis in THA using the direct anterior approach (DAA). Both devices tracked changes in the pelvic position. Methods: In this single-centre, retrospective study, we reviewed 115 hips in 113 patients who underwent primary THA via the DAA using an accelerometer-based portable navigation system in the supine position (portable navigation group) and 106 hips in 101 patients who underwent THA using an acetabular alignment guide (alignment guide group) as controls. Hips were evaluated postoperatively using computed tomography to measure cup orientation. The accuracy of cup orientation was compared between the 2 groups. Results: Absolute values of inclination error were 3.1° ± 2.2° and 2.9° ± 2.3° ( p = 0.708) in the portable navigation and alignment guide groups and those of anteversion error were 2.8° ± 2.3° and 3.7° ± 2.7°, respectively ( p = 0.005). The number of cups placed within 10° of error was 98.3% and 96.2% in the portable navigation and alignment guide groups, respectively ( p = 0.304). The portable navigation group had significantly more hips (72.2%) placed within a 5° margin of error than did the alignment guide group (56.6%) ( p = 0.016). Conclusion: High accuracy in cup placement was achieved using accelerometer-based portable navigation in supine THA. Using a navigation system may contribute to improved long-term outcomes.

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Accuracy of cup orientation and learning curve of the accelerometer-based portable navigation system for total hip arthroplasty in the supine position

Journal of Orthopaedic Surgery ◽

10.1177/2309499019848871 ◽

2019 ◽

Vol 27 (2) ◽

pp. 230949901984887 ◽

Cited By ~ 4

Author(s):

Tomoyuki Kamenaga ◽

Shinya Hayashi ◽

Shingo Hashimoto ◽

Tomoyuki Matsumoto ◽

Koji Takayama ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Learning Curve ◽

Hip Arthroplasty ◽

Supine Position ◽

Navigation System ◽

Total Hip ◽

Portable Navigation

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Improving registration accuracy during total hip arthroplasty: a cadaver study of a new, 3-D mini-optical navigation system

Hip International ◽

10.5301/hipint.5000533 ◽

2017 ◽

Vol 28 (1) ◽

pp. 33-39 ◽

Cited By ~ 7

Author(s):

Michael B. Cross ◽

Ran Schwarzkopf ◽

Theodore T. Miller ◽

Eric A. Bogner ◽

Jeffrey M. Muir ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Navigation System ◽

Cadaver Study ◽

Mean Difference ◽

Reference Plane ◽

Absolute Difference ◽

Registration Error ◽

Total Hip ◽

The Mean

Introduction: Maintaining accuracy of component placement is an important step in ensuring the long-term stability of components during total hip arthroplasty (THA). Computer-assisted navigation has improved accuracy but errors associated with the registration process are known to impact the accuracy of final measurements. The purpose of this cadaver study was to determine the registration error associated with a novel mini-navigation system. Methods: 3 board-certified orthopaedic surgeons performed 4 THA procedures each via the posterolateral approach on 6 cadavers (12 hips) using the mini-navigation tool. Pre- and post-operative radiographs and post-operative computed tomography (CT) images were obtained. Image analysis was performed by 2 radiologists not involved in the surgical procedures. During registration, surgeons aligned the alignment rod with the anterior pelvic plane (APP) to provide a reference plane for comparison with traditional navigation. Cup position from the device was compared with measurements gathered from post-op imaging. Results: The mean difference between CT and device measurements for inclination was -1.7° (standard deviation [SD] 4.9°), while the mean absolute difference was 4.2° (SD 3.2°). The mean difference between anteversion angles calculated from CT scans and from the device was -3.5° (SD 4.5°), with an absolute difference of 4.0° (SD 4.0°). 100% (12/12) of inclination measurements and 92% (11/12) of anteversion measurements fell within both the clinical and statistical limits of agreement when analyzed via the Bland-Altman technique. Conclusions: This study demonstrates that the registration error associated with this new mini-navigation system compares favourably with the known registration error associated with traditional navigation systems.

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Efficacy of a computed tomography-based navigation system for placement of the acetabular component in total hip arthroplasty for developmental dysplasia of the hip

Journal of Orthopaedic Surgery ◽

10.1177/2309499017727954 ◽

2017 ◽

Vol 25 (3) ◽

pp. 230949901772795 ◽

Cited By ~ 4

Author(s):

Takahiko Tsutsui ◽

Tomohiro Goto ◽

Keizo Wada ◽

Tomoya Takasago ◽

Daisuke Hamada ◽

...

Keyword(s):

Computed Tomography ◽

Total Hip Arthroplasty ◽

Acetabular Component ◽

Hip Arthroplasty ◽

Navigation System ◽

Developmental Dysplasia ◽

Total Hip ◽

Dysplasia Of The Hip

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Clinical efficacy of orthopilot navigation system versus conventional manual of total hip arthroplasty

Medicine ◽

10.1097/md.0000000000015471 ◽

2019 ◽

Vol 98 (20) ◽

pp. e15471

Author(s):

Jianguo Jia ◽

Qun Zhao ◽

Pei Lu ◽

Guiyong Fan ◽

Hao Chen ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Clinical Efficacy ◽

Hip Arthroplasty ◽

Navigation System ◽

Total Hip ◽

System Versus

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Clinical efficacy of OrthoPilot navigation system versus conventional manual total hip arthroplasty: A systematic review and meta‐analysis

Journal of International Medical Research ◽

10.1177/0300060518819378 ◽

2019 ◽

Vol 47 (2) ◽

pp. 505-514 ◽

Cited By ~ 2

Author(s):

Cheng-long Chen ◽

Peng-fei Han ◽

Zhi-liang Zhang ◽

Xiao-juan Sun ◽

Zhi Lv

Keyword(s):

Total Hip Arthroplasty ◽

Clinical Efficacy ◽

Hip Arthroplasty ◽

Navigation System ◽

Meta Analysis ◽

Operation Time ◽

Complication Rates ◽

Total Hip ◽

Conventional Procedure ◽

Navigation Group

Objective This study was performed to compare the clinical efficacy between the OrthoPilot navigation system and conventional manual surgery in patients undergoing total hip arthroplasty. Methods The Embase, PubMed, CINAHL, and Cochrane databases were searched for clinical trials. The outcome measurements were the anteversion angle, inclination angle, and complications. Review Manager 5.3 statistical software was used for the data analysis. Results Significant differences were found in the femoral offset and overall complication rate between the conventional and navigation groups. Additionally, the conventional group had significantly less anteversion than the navigation group. However, the navigation group had significantly better inclination. The operation time was significantly shorter in the conventional than navigation group. Conclusion Both the OrthoPilot navigation system and conventional total hip arthroplasty result in significant improvements in patient function with similar overall complication rates and have their own advantages in achieving good cup position. The conventional procedure has a shorter operation time than does use of a navigation system.

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Validity of intraoperative imageless navigation (Naviswiss) for component positioning accuracy in primary total hip arthroplasty: protocol for a prospective observational cohort study in a single-surgeon practice

BMJ Open ◽

10.1136/bmjopen-2020-037126 ◽

2020 ◽

Vol 10 (10) ◽

pp. e037126

Author(s):

Nalan Ektas ◽

Corey Scholes ◽

Alejandro M Ruiz ◽

John Ireland

Keyword(s):

Cohort Study ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Navigation System ◽

Observational Cohort Study ◽

Prospective Observational Cohort Study ◽

Leg Length ◽

Total Hip ◽

Imageless Navigation ◽

Observational Cohort

IntroductionOptimal outcomes in total hip arthroplasty (THA) are dependent on appropriate placement of femoral and acetabular components, with technological advances providing a platform for guiding component placement to reduce the risk of malpositioned components during surgery. This study will validate the intraoperative data captured using a handheld imageless THA navigation system against postoperative measurements of acetabular inclination, acetabular version, leg length and femoral offset on CT radiographs.Methods and analysisThis is a prospective observational cohort study conducted within a single-centre, single-surgeon private practice. Data will be collected for 35 consecutive patients (>18 years) undergoing elective THA surgery, from the research registry established at the surgeon’s practice. The primary outcome is the agreement between intraoperative component positioning data captured by the navigation system compared with postoperative measurements using CT. A total of ten CT scans will be reassessed for interobserver and intraobserver reliability. The influence of patient and surgical factors on the accuracy of component position will also be examined with multivariable linear regression.Ethics and disseminationEthics approval for this study was provided through a certified ethics committee (Bellberry HREC approval number 2017-07-499). The results of this study will be disseminated through peer-reviewed journals and conference presentations.Trial RegistrationAustralian and New Zealand Clinical Trials Registry (ANZCTR) Trial ID: ACTRN12620000089932.

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