scholarly journals A Simple Mathematical Standardized Measurement of Acetabulum Anteversion after Total Hip Arthroplasty

2008 ◽  
Vol 9 (2) ◽  
pp. 105-119 ◽  
Author(s):  
Chen-Kun Liaw ◽  
Rong-Sen Yang ◽  
Sheng-Mou Hou ◽  
Tai-Yin Wu ◽  
Chiou-Shann Fuh
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Measuring Method ◽  
Acetabular Cup ◽  
Total Hip ◽  
Significant Difference ◽  
Precise Tool ◽  
Repeatability Standard Deviation ◽  
The Difference ◽  
American Society

We invented a standardization method to measure the cup's anteversion after total hip arthroplasty without the influence of patient's position. We measured 68 radiographs of 10 patients after total hip replacement (THR) and calculated the error of each measurement, defined as the difference with the average of the same measuring method on the same patient. We also calculated the repeatability standard deviation (RSD) of each method according to the American Society for Testing and Materials, ASTM E691.Mean absolute inter-examination angle error, defined as the average of the absolute deviations, was 0.75° for standardized anteversion (range 0.03–2.51°), as compared with those without standardization, 2.30° (range 0.04–13.04°). The inter-examination measurement reliability (precision), defined as one RSD, was 0.99° for standardized anteversion, as compared with those without standarization, 3.50°. There is no difference between patients four and five without (p = 0.097). There is a significant difference with standardization (p < 0.0001).Our study demonstrated that this mathematical method is a precise tool to measure the anteversion of the acetabular cup. We hope that it can be used widely in the future.

scholarly journals Accuracy of Image-less Navigation for Functional Cup Positioning in Total Hip Arthroplasty

10.29007/3lbz ◽  
2019 ◽  
Author(s):  
Morteza Meftah ◽  
Vinnay Siddappa ◽  
Jeffery Muir ◽  
Peter White
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Weight Bearing ◽  
Safe Zone ◽  
Computer Assisted ◽  
Acetabular Cup ◽  
Assisted Navigation ◽  
Total Hip ◽  
Significant Difference ◽  
Cup Positioning

Computer-assisted navigation has the potential to improve the accuracy of cup positioning during total hip arthroplasty (THA) and prevent leg length discrepancy (LLD). The purpose of this study was to compare acetabular cup position and post- operative LLD after primary THA using posterolateral approach. Between August 2016 to December 2017, 57 THAs using imageless navigation were matched with 57 THA without navigation, based on age, gender and BMI. Post-operative weight-bearing radiographs were assessed using for anteversion, inclination and LLD. Goal for functional cup placement was 40° inclination and 20° anteversion based on preoperative weight bearing pelvic images. Functional LLD was measured as compared to pre- operative radiographs and contralateral side. Proportion of cups within Lewinnek’s safe zone, proximity to a pre-operative target of and the LLD &gt;5 mm was assessed. The mean age was 54.9 ± 9.6 years (30 – 72) and 57.6 ± 12.5 years (20 – 85) in control and navigated groups, respectively. Mean cup orientation in the navigated group was 20.6°± 3.3° (17 - 25) of anteversion and 41.9°± 4.8° (30 - 51) of inclination, vs. 25.0°± 11.1° (10 - 31) and 45.7°± 8.7° (29 – 55) in control group, where were statistically significant (p=0.005 and p=0.0001), respectively. In the navigated group, significantly more acetabular cups were placed within Lewinnek’s safe zone (anteversion: 78% vs. 47%, p=0.005; inclination: 92% vs. 67%, p=0.002). There was no significant difference in mean LLD in navigation and control groups (3.1 ± 1.5 mm vs. 4.6 ± 3.4 mm, p=0.36), although fewer LLDs &gt;5 mm were reported in the navigated group (7.1%) than in controls (31.4%, p=0.007). The use of this image-less computer-assisted navigation improved the accuracy with which acetabular cup components were placed and may represent an important method for limiting post-operative complications related to cup malpositioning and LLD.

Mobility Limitation After Surgery for Degenerative Pathology of the Ankle, Hindfoot, and Midfoot vs Total Hip Arthroplasty

2020 ◽  
Vol 41 (5) ◽  
pp. 501-507
Author(s):  
Gregory Kurkis ◽  
Amalie Erwood ◽  
Samuel David Maidman ◽  
Wesley J. Manz ◽  
Ehab Nazzal ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Mobility Limitation ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Total Hip ◽  
Ankle Surgery ◽  
Significant Difference ◽  
Postoperative Mobility ◽  
The Difference

Background: Surgery for degenerative foot and ankle conditions often results in a lengthy recovery. Current outcome measures do not accurately assess postoperative mobility, especially in older patients. The Life-Space Assessment (LSA), a questionnaire quantifying patients’ mobility after a medical event, was used in this study to assess perioperative mobility in total hip arthroplasty (THA) and foot and ankle surgery patients. We hypothesized that patients undergoing elective foot and ankle surgery would have greater postoperative mobility limitation than THA patients. Methods: Preoperative, 3-month, and 6-month postoperative LSA data were collected from THA and foot and ankle cohorts. Twelve-month postoperative data were obtained for the foot and ankle group as well. Patient demographics were recorded, and data were analyzed using a Mann-Whitney U test. Results: Twenty-eight degenerative foot and ankle operative patients and 38 THA patients met inclusion criteria. Only patients aged ≥60 years were included in this study. The mean preoperative LSA score was lower in the foot and ankle group (68.8) compared with THA (74.0), although the difference was not statistically significant ( P = .602). THA patients showed a significant increase in LSA score from preoperative (74) to 6 months postoperation (95.9) ( P = .003); however, foot and ankle patients showed no significant difference between preoperative (68.8) and 6-month (61.2) scores ( P = .468). Twelve months postoperatively, foot and ankle patients showed improvement in LSA score (88.3) compared with preoperation ( P = .065). Conclusion: Compared with THA, recovery of mobility after foot and ankle surgery was slower. THA patients exhibited improved mobility as early as 3 months after surgery, whereas foot and ankle patients did not show full improvement until 12 months. This work will assist the foot and ankle specialist in educating patients about challenges in mobility during their recovery from surgery. Level of Evidence: Level II, prospective cohort study.

scholarly journals Relationship Between the Accuracy of Acetabular Cup Angle and Body Mass Index in Posterolateral Total Hip Arthroplasty With CT-Based Navigation: A Retrospective Case-Control Study

2020 ◽  
Author(s):  
Hisatoshi Ishikura ◽  
Masaki Nakamura ◽  
Hanae Nishino ◽  
Shigeru Nakamura ◽  
Takeyuki Tanaka ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Total Hip Arthroplasty ◽  
Body Mass ◽  
Hip Arthroplasty ◽  
Acetabular Cup ◽  
Total Hip ◽  
Significant Difference ◽  
The Mean ◽  
Navigation Errors ◽  
The Relationship

Abstract Background: Precise acetabular cup placement is essential for successful total hip arthroplasty (THA). In obese patients, its accuracy is often difficult to achieve because of the thickness of the soft tissues. This study aimed to determine the relationship between the accuracy of acetabular cup angle and body mass index (BMI) in posterolateral THA using the computed tomography-based navigation (CT-navi) system.Methods: We retrospectively reviewed 145 consecutive primary THAs using the CT-navi system between January 2015 and January 2018. All surgeries were performed using cementless cups employing the posterolateral approach with the patient in the decubitus position. We compared the radiographic inclination and anteversion obtained from the angle displayed on the CT-navi screen with those measured by the postoperative CT using the three-dimensional templating software. We evaluated the relationship between the extent of errors and correlation with BMI. Statistical analyses were performed using the Student’s t-test and Spearman’s rank coefficient test.Results: In non-overweight patients (BMI < 25, 88 hips), the mean navigation errors for inclination were 2.8 ± 2.2° and for anteversion were 2.6 ± 2.3°. Meanwhile, in overweight patients (BMI ≥ 25, 57 hips), the mean navigation errors were 2.6 ± 2.4° for inclination and 2.4 ± 2.4° for anteversion. We found no significant difference between overweight and non-overweight patients in both inclination and anteversion. The Spearman’s rank correlation coefficients were -0.04 for inclination and -0.11 for anteversion, showing no correlation between the extent of errors and BMI.Conclusions: In posterolateral THA, CT-navi can aid the precise placement of the acetabular cup irrespective of a patient’s BMI.Trial registration: This trial was retrospectively registered and approved by the institutional ethics committee of Teikyo University. The registration number is 17-190, and the date of approval was March 1, 2018. URL of trial registry is: https://www.teikyo-u.ac.jp/application/files/7015/8432/1341/2016_all_syounin_1.pdf

scholarly journals An accelerometer-based navigation system provides acetabular cup orientation accuracy comparable to that of computed tomography-based navigation during total hip arthroplasty in the supine position

2019 ◽  
Author(s):  
Tomonori Tetsunaga ◽  
Kazuki Yamada ◽  
Tomoko Tetsunaga ◽  
Tomoaki Sanki ◽  
Yoshi Kawamura ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Supine Position ◽  
Polyethylene Wear ◽  
Anterolateral Approach ◽  
Navigation Systems ◽  
Acetabular Cup ◽  
Total Hip ◽  
Significant Difference

Abstract Background: Inadequate acetabular component orientation is associated with postoperative impingement, dislocation, and accelerated polyethylene wear. Computed tomography (CT)-based navigation systems provide accuracy for total hip arthroplasty (THA) but are not available in all facilities. Accelerometer-based navigation systems are inexpensive, but their accuracy remains undetermined. This study compares the accuracy of cup orientation in THA using CT-based and accelerometer-based navigation systems. Methods: This retrospective study included 35 consecutive patients (11 males, 24 females; mean age, 65 years) who underwent primary cementless THA via an anterolateral approach in the supine position. Both CT-based and accelerometer-based navigation systems were used simultaneously. The accuracy of cup orientation was compared between the two systems using postoperative CT. Results: The accuracy of cup inclination was 2.7° ± 2.0° in the CT-based group and 3.3° ± 2.4° in the accelerometer-based group. The accuracy of cup anteversion was 2.8° ± 2.6° in the CT-based group and 3.4° ± 2.2° in the accelerometer-based group. No significant difference was observed in cup inclination ( p = 0.29) or cup anteversion ( p = 0.34) between CT-based and accelerometer-based navigation. Conclusions: The accuracy of cup positioning did not differ significantly between CT-based and accelerometer-based navigation systems.

scholarly journals Impact of Surgeon Handedness in Manual and Robot-assisted Total Hip Arthroplasty

2020 ◽  
Author(s):  
Xiangpeng Kong ◽  
Minzhi Yang ◽  
Xiang Li ◽  
Ming Ni ◽  
Guoqiang Zhang ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Acetabular Cup ◽  
Robot Assisted ◽  
Total Hip ◽  
Significant Difference ◽  
Manual Group ◽  
The Impact ◽  
Cup Positioning

Abstract Background: The purpose of this study was to examine whether surgeon handedness could affect cup positioning in manual total hip arthroplasty (THA), and whether robot could diminish or eliminate the impact of surgeon handedness on cup positioning in robot-assisted THA.Methods: Fifty-three patients who underwent bilateral robot-assisted THA and sixty-two patients who underwent bilateral manual THA between August 2018 and July 2019 in our institute were respectively analyzed in this study. When the difference between the bilateral anteversion or inclination was greater than 5°, the patient was regarded as having different cup positioning between bilateral THA. Their demographics, orientation of acetabular cup and postoperative 3 month Harris hip score (HHS) were recorded for analysis. Results: There were no significant difference in the gender, age, BMI, diagnosis’s composition, preoperative and postoperative HHS between the robotic and manual group. Two left hips dislocated in the manual group. The anteversion of left hip was significantly larger than that of right hip (24.77±10.44 vs 22.44±8.67, p=0.043) in the manual group. There were no significant difference of cup positioning between bilateral robot-assisted THA. The patients in manual group were significantly more likely to have different cup positioning between bilateral hips than those in robotic group (77% vs 45%, p=0.000). More manual THA were located out of the target zone than robot-assisted THA (70% vs 48%, p=0.001). Conclusions: Surgeon’s handedness showed a trend towards an impact on cup positioning in manual THA and robot might help surgeon eliminate the adverse impact. However, the impact of handedness on the clinical outcomes still needs further observation.

scholarly journals Which one is more affected by navigation-assisted cup positioning in total hip arthroplasty: Anteversion or inclination? A retrospective matched-pair cohort study in Asian physique

2018 ◽  
Vol 26 (2) ◽  
pp. 230949901878075 ◽  
Author(s):  
Kwang Jun Oh ◽  
Byung Kag Kim ◽  
Myung Il Jo ◽  
Byung Mun Ahn
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Matched Pair ◽  
Mean Deviation ◽  
Acetabular Cup ◽  
Total Hip ◽  
Imageless Navigation ◽  
Significant Difference ◽  
Matching Criteria ◽  
Cup Positioning

Introduction: The purpose of this study was to compare acetabular cup positioning using an imageless navigation-assisted total hip arthroplasty (THA) to a case-matched control group using the conventional technique in Asian physique. Methods: Case matching controlled study using retrospectively collected data for THAs was done. Matching criteria were gender, age ± 5 years, and body mass index ± 5 kg/m2. Thirty patients who had navigation THAs were manually matched to a conventional group of 30 patients. After measuring anteversion and inclination on 3-D CT, final cup anteversion was calculated using the mathematical formula (anteversion = arctan [tan (anatomic anteversion) × sin (inclination)]). Results: No significant difference was observed between mean inclination ( p = 0.420), anteversion ( p = 0.697), and the mean deviation from 15° for anteversion ( p = 0.649). However, there was a statistical significant difference for mean deviation from 40° for inclination ( p = 0.027). There was a significant difference in the percentage of correctly placed acetabular cup in safe zones with inclination ( p = 0.039). Conclusions: Although soft tissue overlying the pubic tubercle interfered with registration of the bony landmark and thereby induced inaccuracy of anteversion angles in the navigation group, the use of imageless navigation-assisted technique increases the placement within the safe zone for inclination and enhances the accuracy and the precision of inclination of the acetabular cup relative to the conventional THA rather than anteversion. This finding may be due to the effect of the patient’s physique on the anterior pelvic plane (APP)-based reference system of imageless navigation.

CT-based automated planning of acetabular cup for total hip arthroplasty (THA) based on hybrid use of two statistical atlases

2016 ◽  
Vol 11 (12) ◽  
pp. 2253-2271 ◽  
Author(s):  
Yoshiyuki Kagiyama ◽  
Itaru Otomaru ◽  
Masaki Takao ◽  
Nobuhiko Sugano ◽  
Masahiko Nakamoto ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Automated Planning ◽  
Acetabular Cup ◽  
Total Hip

Assessment of an Orthopaedic Templating Software Package for Uncemented Total Hip Arthroplasty

2020 ◽  
Vol 4 (04) ◽  
pp. 155-157
Author(s):  
Michael Newman ◽  
David Hartwright
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Acetabular Cup ◽  
Total Hip ◽  
Pelvic Radiograph ◽  
Uncemented Total Hip Arthroplasty ◽  
Femoral Stems ◽  
Hip Arthroplasties ◽  
Acetabular Components ◽  
Insight Into

AbstractThe aim of this study was to assess a large, single-surgeon dataset of uncemented total hip arthroplasties that had been templated using software. This assessment compared preoperative templated predictions with what was implanted with regard to (1) femoral prosthesis size and (2) acetabular cup size. The operation notes for two types of uncemented total hip arthroplasty performed by a single surgeon between January 9, 2008, and March 21, 2019, were assessed. The data were refined so that only those that were fully templated on a correctly calibrated pelvic radiograph were included. This provided a total of 153 cases. The predicted software template was compared with actual implanted component sizes. With regard to the femoral stems, the templating software was exactly correct in 45.75% of cases and was accurate to within one size in 87.59% of cases. With regard to the acetabular component, the templating software was exactly correct in 52.94% of cases and was accurate to within one size (2 mm) in 86.94% of cases. Templating software offers an accurate prediction of the size of uncemented femoral and acetabular components. In addition, the benefits of templating include cognitive rehearsal, insight into potentially challenging aspects of surgery, and highlighting intraoperative issues where there is a large intraoperative deviation from what is templated. This study demonstrates the congruence and reproducibility of templating software when compared with other smaller studies performed in the literature.

scholarly journals Short-stem total hip arthroplasty is not associated with an earlier return to work compared to a straight-stem design

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Georg Hauer ◽  
Maria Smolle ◽  
Sabrina Zaussinger ◽  
Joerg Friesenbichler ◽  
Andreas Leithner ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Sick Leave ◽  
Return To Work ◽  
Hip Arthroplasty ◽  
Short Stem ◽  
Multivariate Linear Regression Analysis ◽  
Stem Design ◽  
Total Hip ◽  
Straight Stem ◽  
Significant Difference

AbstractReturn to work (RTW) has been specifically identified as a high priority in patients undergoing total hip arthroplasty (THA). This investigation sought to assess the effect of the stem design on patients’ RTW. Secondly, the study aimed to identify risk factors that lead to a delayed RTW. Questionnaires inquiring about RTW, employment history, educational level, type of work, physical demands and joint awareness were administered by post. Further data were collected from patients’ hospital records. 176 patients who underwent THA using a short-stem and 97 patients using a straight-stem design were compared. The median return to work time was 10 weeks [IQR 7–14 weeks], with no significant difference between the two groups (short stems vs. straight stems; 10 [IQR 7–14] vs. 11 [7.5–13.5] weeks; p = 0.693). In the multivariate linear regression analysis, self-employment vs. employee (p = 0.001), dimension of preoperative workload (p = 0.001), preoperative sick leave (p < 0.001), and hospital length of stay (LOS) (p < 0.001) independently affected the period until work was resumed. The Forgotten-Joint-Score-12 showed no significant difference between the two groups. The data show that the majority of THA patients can expect to resume work and stem design has no impact on RTW. Employees with preoperative sick leave, prolonged hospital LOS and low workload are at higher risk for a delayed RTW.

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