Comparison of accuracy of cup position using portable navigation versus alignment guide in total hip arthroplasty in supine position

2020 ◽  
pp. 112070002090878 ◽  
Author(s):  
Masanori Okamoto ◽  
Masashi Kawasaki ◽  
Toshiaki Okura ◽  
Satoshi Ochiai ◽  
Hiroyuki Yokoi
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Supine Position ◽  
Navigation System ◽  
Direct Anterior Approach ◽  
Navigation Systems ◽  
Total Hip ◽  
Navigation Group ◽  
Portable Navigation ◽  
Alignment Guide

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.

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

2019 ◽  
Vol 27 (2) ◽  
pp. 230949901984887 ◽  
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

scholarly journals Differences in the setting of acetabular component alignment guides between the supine and lateral positions for total hip arthroplasty

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yukihide Minoda ◽  
Ryo Sugama ◽  
Yoichi Ohta ◽  
Susumu Takemura ◽  
Nobuo Yamamoto ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Supine Position ◽  
Clinical Results ◽  
Lateral Position ◽  
Navigation Systems ◽  
Component Alignment ◽  
Total Hip ◽  
Alignment Guide

AbstractThe acetabular component orientation in total hip arthroplasty is of critical importance to clinical results. Although navigation systems and surgical robots have been introduced, most surgeons still use acetabular component alignment guides. This study aimed to compare the accuracy between modern acetabular component alignment guides for the lateral position and those for the supine position. Thirteen alignment guides for the lateral position and 10 for the supine position were investigated. All the lateral position alignment guides indicated cup alignment in operative definition, and the supine position alignment guides indicated cup alignment in radiographic definition. For lateral position alignment guides, the anteversion actually indicated by the alignment guide itself was smaller than that indicated by the manufacturer by a mean of 6° (maximum, 9°), and the inclination actually indicated by alignment guides themselves was larger than that by the manufacturer (p < 0.01) by a mean of 2° (maximum, 4°). For supine position alignment guides, the inclination and anteversion indicated by the alignment guide itself were identical with those indicated by the manufacturer. The current study showed that the angles actually indicated and those stated by manufacturers were not identical for lateral position alignment guides.

scholarly journals The Accuracy of Acetabular Cup Placement in Primary Total Hip Arthroplasty Using an Image-free Navigation System

2021 ◽  
Author(s):  
Yohei Naito ◽  
Masahiro Hasegawa ◽  
Shine Tone ◽  
Hiroki Wakabayashi ◽  
Akihiro Sudo
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Navigation System ◽  
Control Group ◽  
Navigation Systems ◽  
Total Hip ◽  
Navigation Group ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Background: Intraoperative navigation systems have been shown to improve the accuracy of acetabular component insertion in total hip arthroplasty (THA). The purpose of this study was to investigate the accuracy of cup orientation in primary THA using an image-free navigation system.Methods: A total of 107 consecutive cementless THAs using an image-free navigation system were performed from February 2017 to March 2020 (the navigation group). As a control group, 77 retrospective consecutive cases who underwent THAs with manual implant-techniques between February 2012 and April 2017 were included. Postoperative cup radiographic inclination and radiographic anteversion relative to the functional pelvic plane were assessed using a 3D-template system after computed tomography (CT) examination.Results: The mean absolute errors of the postoperative measured angles from the target angles in inclination were 3.4°±3.0° in the navigation group and 8.4°±6.6° in the control group (p<0.001). The mean absolute errors in anteversion were 5.1° ± 3.6° in the navigation group and 10.8° ± 6.5° in the control group (p<0.001). The percentage of cups inside the Lewinnek safe zone was 93% in the navigation group and 44% in the control group (p<0.001). The mean absolute values of navigation error were 3.3° ± 2.8° in inclination and 5.8° ± 4.9° in anteversion. Among the cases of osteoarthritis, the inclination error was significantly higher in Crowe group 2 to 4 than in Crowe group 1 (5.1° ± 3.5° and 3.0° ± 2.5°, respectively, p<0.05). The percentage of hips with inclination error over 10° in Crowe group 2 to 4 was significantly higher than in Crowe group 1 (17% and 1%, respectively, p<0.05).Conclusions: The image-free navigation system improved the accuracy of cup orientation. The accuracy of cup position was less in Crowe group 2 to 4 than in Crowe group 1.

Comparison of the accuracy of CT- and accelerometer-based navigation systems for cup orientation in total hip arthroplasty

2020 ◽  
pp. 112070002090494 ◽  
Author(s):  
Tomonori Tetsunaga ◽  
Kazuki Yamada ◽  
Tomoko Tetsunaga ◽  
Takayuki Furumatsu ◽  
Tomoaki Sanki ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Navigation System ◽  
Pelvic Tilt ◽  
Lateral Decubitus Position ◽  
Absolute Difference ◽  
Navigation Systems ◽  
Total Hip ◽  
Navigation Group ◽  
Lateral Decubitus

Background: The accuracies of various navigation systems in total hip arthroplasty (THA) have been described; however, the accuracy of cup orientation with an accelerometer-based navigation system has not been reported. The purpose of this study was to compare the accuracies of computed tomography (CT)- and accelerometer-based navigation systems for cup orientation in THA. Methods: In this prospective study, 30 patients who underwent cementless THA via anterolateral approach in the lateral decubitus position were analysed. A CT-based navigation system (30 hips) and an accelerometer-based navigation system (30 hips) were used simultaneously. The accuracy of cup orientation (absolute difference between intraoperative vs. postoperative measurements) was compared between the navigation systems using postoperative CT. Results: The accuracy of cup inclination was 3.2 ± 2.4° in the CT-based navigation group and 4.1 ± 3.7° in the accelerometer-based navigation group ( p = 0.3035). The accuracy of cup anteversion was 3.0° ± 2.5° in the CT-based navigation group and 6.8° ± 4.8° in the accelerometer-based navigation group. Cup anteversion was significantly more accurate with the CT-based navigation system than with accelerometer-based navigation ( p = 0.0009). Multiple regression analysis demonstrated that the malposition in cup anteversion was positively correlated with the change in pelvic tilt and loosening of the reference antenna. Conclusions: Although, these results are only true for this specific accelerometer system, cup positioning was significantly more accurate with the CT-based navigation system than an accelerometer-based navigation in the lateral decubitus position. This is because of considerable discrepancies in the sagittal pelvic tilt, resulting in variability in cup anteversion angle with the use of an accelerometer-based navigation system.

scholarly journals The Accuracy And Influencing Factors of An Accelerometer-Based Portable Navigation System For Total Hip Arthroplasty In The Supine Position : A Prospective Multicenter Study Using 3D CT Measurement

2021 ◽  
Author(s):  
Yukihide Minoda ◽  
Masayuki Ito ◽  
Kentaro Iwakiri ◽  
Katsufumi Uchiyama ◽  
Masashi Kawasaki ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Supine Position ◽  
Navigation System ◽  
Pelvic Tilt ◽  
Intraoperative Navigation ◽  
3D Ct ◽  
Pelvic Rotation ◽  
Total Hip ◽  
Portable Navigation

Abstract This multicenter prospective study aimed to evaluate the accuracy of a newly introduced accelerometer-based portable navigation system for total hip arthroplasty (THA) in the supine position. Three hundred twenty-four THAs using supine position in 9 hospitals were prospectively enrolled in the study. An accelerometer-based portable navigation system was used for cup fixation and the intraoperative navigation data (cup alignment, pelvic tilt, and pelvic rotation) were recorded. Postoperative cup alignment was measured on 3D-CT images. The accuracy (absolute difference in cup alignment between the intraoperative navigation record and postoperative 3D-CT measurements) was 3 ± 3° (mean ± standard deviation) for cup inclination and 3 ± 3° for cup anteversion. The pelvis tilted anteriorly in 148 hips (46%) and posteriorly in 162 hips (50%), and did not tilt in 14 hips (4%). The pelvis rotated toward the operating side in 179 hips (55%), toward the contralateral side in 112 hips (35%), and did not rotate in 33 hips (10%). Multiple regression analysis showed that the patients’ characteristics, pelvic tilt, and pelvic rotation did not affect the accuracy of the navigation system. The accuracy was 3 ± 3° and not affected by patient characteristics, surgical factors, or substantial pelvic movement during cup fixation.

scholarly journals The accuracy of acetabular cup placement in primary total hip arthroplasty using an image-free navigation system

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yohei Naito ◽  
Masahiro Hasegawa ◽  
Shine Tone ◽  
Hiroki Wakabayashi ◽  
Akihiro Sudo
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Navigation System ◽  
Control Group ◽  
Navigation Systems ◽  
Total Hip ◽  
Navigation Group ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Background Intraoperative navigation systems have been shown to improve the accuracy of acetabular component insertion in total hip arthroplasty (THA). The purpose of this study was to investigate the accuracy of cup orientation in primary THA using an image-free navigation system. Methods A total of 107 consecutive cementless THAs using an image-free navigation system were performed from February 2017 to March 2020 (the navigation group). As a control group, 77 retrospective consecutive cases who underwent THAs with manual implant-techniques between February 2012 and April 2017 were included. Postoperative cup radiographic inclination and radiographic anteversion relative to the functional pelvic plane were assessed using a 3D-template system after computed tomography (CT) examination. Results The mean absolute errors of the postoperative measured angles from the target angles in inclination were 3.4° ± 3.0° in the navigation group and 8.4° ± 6.6° in the control group (p < 0.001). The mean absolute errors in anteversion were 5.1° ± 3.6° in the navigation group and 10.8° ± 6.5° in the control group (p < 0.001). The percentage of cups inside the Lewinnek safe zone was 93% in the navigation group and 44% in the control group (p < 0.001). The mean absolute values of navigation error were 3.3° ± 2.8° in inclination and 5.8° ± 4.9° in anteversion. Among the cases of osteoarthritis, the inclination error was significantly higher in Crowe group 2 to 4 than in Crowe group 1 (5.1° ± 3.5° and 3.0° ± 2.5°, respectively, p < 0.05). The percentage of hips with inclination error over 10° in Crowe group 2 to 4 was significantly higher than in Crowe group 1 (17 and 1%, respectively, p < 0.05). Conclusions The image-free navigation system improved the accuracy of cup orientation. The accuracy of cup position was less in Crowe group 2 to 4 than in Crowe group 1.

scholarly journals Direct Anterior Approach for Total Hip Arthroplasty in the Lateral Decubitus Position Versus Supine Position: A Random Clinical Trial

2021 ◽  
Author(s):  
Yao Xiao ◽  
Zhanglai Li ◽  
Feitai Lin ◽  
Yiyuan Zhang ◽  
Yan Weng ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Supine Position ◽  
Anterior Approach ◽  
Direct Anterior Approach ◽  
Lateral Position ◽  
Lateral Decubitus Position ◽  
Population Characteristics ◽  
Total Hip ◽  
Lateral Decubitus

Abstract Background: Direct anterior approach (DAA）for total hip arthroplasty (THA）could be performed either in the lateral decubitus position or supine position. However, there is an obvious absence of literature regarding the differences, which position may be more conducive to recovery, technically more demanding, associated with component malposition or more complications. Methods: From Jan.1st, 2020 to oct.1st, 2020, 45 patients were recruited for primary unilateral THA using the DAA. In total, 27 patients (60%) underwent THAs using the DAA in the supine position, and 18 patients (40%) in the lateral decubitus position. All surgeries were performed by a high-volume surgeon. Technical information, clinical and radiographic outcomes, SF-12 and patient-reported outcomes such as WOMAC were evaluated. All the date were tested with Generalized Linear Mixed Models Analysis, GLM Repeated Measurement Analysis, Independent samples t-test or Pearson’s chi-square test.Results: There were no differences in Population characteristics before surgery. The operation time, length of stay and blood loss in the LP group and the SP group were no differences. The prosthesis of the two groups were in a good position. pre-operative and the first and third day after the surgery of CK-MB and Hb,pre-operative and the last follow-up of HSS,WOMAC,UCLA,VAS,SF-12,and pre-operation and post-operation of Offset,FA and LLD, all the above indicators show no significant difference. And the incidence of complications in the lateral position was lower than that in the supine position.Conclusion: Both THA via DAA in the lateral decubitus position and in the supine position produced excellent clinical outcomes. From the perspective of the occurrence of complications, we are more inclined to use the lateral position.

scholarly journals Axial pelvic tilt in direct anterior Total hip Arthroplasty using a traction table

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
A. Aichmair ◽  
M. Dominkus ◽  
J. G. Hofstaetter
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Supine Position ◽  
Pelvic Tilt ◽  
Patient Positioning ◽  
Direct Anterior Approach ◽  
Operating Table ◽  
Inclusion Criteria ◽  
Single Institution ◽  
Total Hip

Abstract Background Direct anterior approach total hip arthroplasty may be undertaken on a traction table, but the effects that patient positioning can have on axial pelvic tilt (aPT) are unknown. The aim of this study was to assess the degree of error from patient positioning on the traction table during anterior minimally-invasive surgery (AMIS) THA. Methods Patients were included who underwent direct anterior THA via the AMIS technique at a single institution between 11/2018 and 03/2019. Axial pelvic tilt was measured (a) in the supine position on the operating table, and (b) after positioning on the traction table, by the same consultant surgeon in all cases. Results In the above-mentioned study period, 50 patients (F: 32; M: 18) with an average age of 60.6 ± 13.6 (range: 26.5 to 88.3) years, and an average BMI of 27.2 ± 5.0 (range: 17.9 to 41.5) kg/m2 met the inclusion criteria. When measured in supine position, the average aPT was − 0.2 ± 1.7 (range: − 5.6 to 3.8) degrees. After positioning on the traction table, the average aPT was − 3.5 ± 2.1 (− 8.5 to 1.6) degrees (p < 0.001). In patients with an aPT of more than 5 degrees, the caput-collum-diaphyseal (CCD) angle was significantly lower (125 ± 11° vs. 134 ± 8°, p = 0.007). Conclusion This study raises awareness for the potential risk of aPT during positioning of the patient on the traction table, commonly used during direct anterior THA via the AMIS technique.

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

2019 ◽  
Vol 47 (2) ◽  
pp. 505-514 ◽  
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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