Patient-specific instrumentation improves the accuracy of acetabular component placement in total hip arthroplasty

2016 ◽  
Vol 98-B (10) ◽  
pp. 1342-1346 ◽  
Author(s):  
L. Spencer-Gardner ◽  
J. Pierrepont ◽  
M. Topham ◽  
J. Baré ◽  
S. McMahon ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Patient Specific ◽  
Component Placement ◽  
Total Hip ◽  
Patient Specific Instrumentation

scholarly journals Patient specific surgical guide improve the accuracy of acetabular component placement in total hip arthroplasty with dysplastic acetabulum

10.29007/frjz ◽  
2019 ◽  
Author(s):  
Peihui Wu ◽  
Weiming Liao ◽  
Yan Kang
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Patient Specific ◽  
Absolute Deviation ◽  
Surgical Guide ◽  
Total Hip ◽  
Rotation Center ◽  
Patient Specific Instrumentation ◽  
3D Ct Scan

To investigate the accuracy of a novel 3D CT scan-based preoperative planning software linked to patient-specific instrumentation (PSI) for placing acetabular components planning in patients with acetabular dysplasia undergoing total hip arthroplasty (THA). A total of 30 consecutive patients were prospectively enrolled and the accuracy of placement of the acetabular component was measured using post- operative CT scans. There was good reproducibility of preoperative and postoperative position of reconstructed rotation center. The mean absolute deviation from the planned inclination and anteversion was 6.2° and 4.8°, respectively. In 90% of cases the planned target of +/-5° was achieved for both inclination and anteversion. And 95% of cases of planned target of +/-3mm were achieved for vertical height of rotation center. Accurate placement of the acetabular component can be achieved using patient-specific guides and is superior to free hand techniques.

Using Intraoperative Pelvic Landmarks for Acetabular Component Placement in Total Hip Arthroplasty

2006 ◽  
Vol 21 (6) ◽  
pp. 832-840 ◽  
Author(s):  
Nicholas G. Sotereanos ◽  
Mark C. Miller ◽  
Brett Smith ◽  
Robert Hube ◽  
Jeffrey J. Sewecke ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Component Placement ◽  
Total Hip

Does Robotic-Assisted Total Hip Arthroplasty Improve Accuracy of Cup Positioning?

2019 ◽  
Vol 03 (04) ◽  
pp. 176-180 ◽  
Author(s):  
Joshua A. Lawson ◽  
Andrew T. Garber ◽  
Jeffrey D. Stimac ◽  
Rama Ramakrishnan ◽  
Langan S. Smith ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Consecutive Series ◽  
Goal Alignment ◽  
Robotic Assisted ◽  
Component Placement ◽  
Total Hip ◽  
Hip Replacements ◽  
Cup Positioning

AbstractAcetabular component malpositioning is a frequent cause of complications in total hip arthroplasty including instability, increased wear, osteolysis, impingement, and revision surgery. Recently, robotics and navigation have been introduced to improve cup positioning in total hip arthroplasty. The purpose of this study was to compare the accuracy of postoperative acetabular component positioning using MAKO robotic-assisted versus manual acetabular component placement. A consecutive series of 100 total hip replacements were performed in 100 patients. The first 50 were performed using manual techniques, while the second 50 were performed using MAKO-guided acetabular component placement. Postoperative anteroposterior pelvis radiographs were used to determine the postoperative anteversion and inclination of the cup relative to the goal of 15 and 45°, respectively. In the manual group, the average anteversion and inclination was 14.3 and 44.2°, respectively, with 28% within 5° and 82% within 10° of the goal alignment, respectively. In the robotic group, the average anteversion and inclination was 15.1 and 45.6°, respectively, with 54 and 88% within 5 and 10° of the goal alignment, respectively. This equated to a statistically significant improvement in the number of acetabular components placed within 5° of the target alignment with the use of robotic guidance (p = 0.0142). From the authors' study, they were able to demonstrate a significant improvement in acetabular component alignment with the use of robotic techniques. Additional studies are needed to demonstrate improvement in clinical outcomes as a result of improved accuracy and precision of acetabular component placement.

Augmented Reality for Acetabular Component Placement in Direct Anterior Total Hip Arthroplasty

2020 ◽  
Vol 35 (6) ◽  
pp. 1636-1641.e3 ◽  
Author(s):  
Clayton Alexander ◽  
Alexander E. Loeb ◽  
Javad Fotouhi ◽  
Nassir Navab ◽  
Mehran Armand ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Component Placement ◽  
Total Hip

scholarly journals Intraoperative evaluation of acetabular cup position during anterior approach total hip arthroplasty: are we accurately interpreting?

2019 ◽  
Vol 30 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Dimitri E Delagrammaticas ◽  
George Ochenjele ◽  
Brett D Rosenthal ◽  
Benjamin Assenmacher ◽  
David W Manning ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Mean Value ◽  
Radiographic Evaluation ◽  
Acetabular Cup ◽  
Component Placement ◽  
Total Hip ◽  
Value Measurement ◽  
Posterior Anterior

Introduction: Intraoperative radiographic evaluation during total hip arthroplasty (THA) has shown to improve the accuracy of acetabular component placement, however, differences in interpretation based on radiographic technique has not been established. This study aims to determine if differences exist in the interpretation of acetabular component abduction and anteversion between different radiographic projections. Methods: 55 consecutive direct anterior THAs in 49 patients were prospectively enrolled. Target anteversion and abduction was defined by the Lewinnek zone. Fluoroscopy was used to direct acetabular component placement intraoperatively. After final cup implantation, fluoroscopic posterior-anterior hip and pelvis images were obtained for analysis. After completion of the procedure, an anterior-posterior plain pelvis radiograph was obtained in the operating room. Acetabulum component abduction and anteversion were postoperatively determined using specialised software on each of the 3 image acquisition methods. Results: Average acetabular cup abduction for intraoperative fluoroscopic posterior-anterior hip (FH), intraoperative fluoroscopic posterior-anterior pelvis (FP), and postoperative, standard, anteroposterior pelvis radiographs (PP) was 40.95° ± 2.87°, 38.87° ± 3.82° and 41.73° ± 2.96° respectively. The fluoroscopic hip and fluoroscopic pelvis tended to underestimate acetabular cup abduction compared to the postoperative pelvis ( p < 0.001). Average acetabular cup anteversion for FH, FP, and PP was 19.89° ± 4.87°, 24.38° ± 5.31° and 13.36° ± 3.52° respectively. Both the fluoroscopic hip and fluoroscopic pelvis overestimated anteversion compared to the AP pelvis, with a 6.38° greater mean value measurement for FH ( p < 0.001), and an 11° greater mean value measurement for FP ( p < 0.001). Conclusions: Fluoroscopic technique and differences between radiographic projections may result in discrepancies in component position interpretation. Our results support the use of the fluoroscopic posterior-anterior hip as the choice fluoroscopic imaging technique.

scholarly journals Advances and innovations in total hip arthroplasty

SICOT-J ◽  
2021 ◽  
Vol 7 ◽  
pp. 26
Author(s):  
Andreas Fontalis ◽  
Jean-Alain Epinette ◽  
Martin Thaler ◽  
Luigi Zagra ◽  
Vikas Khanduja ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Three Dimensional ◽  
Young Patients ◽  
Cost Effective ◽  
Patient Specific ◽  
Three Dimensional Printing ◽  
Total Hip ◽  
Patient Specific Instrumentation ◽  
Dimensional Printing

Total hip arthroplasty (THA) has been quoted as one of the most successful and cost-effective procedures in Orthopaedics. The last decade has seen an exponential rise in the number of THAs performed globally and a sharp increase in the percentage of young patients hoping to improve their quality of life and return to physically demanding activities. Hence, it is imperative to review the various applications of technology in total hip arthroplasty for improving outcomes. The development of state-of-the-art robotic technology has enabled more reproducible and accurate acetabular positioning, while long-term data are needed to assess its cost-effectiveness. This opinion piece aims to outline and present the advances and innovations in total hip arthroplasty, from virtual reality and three-dimensional printing to patient-specific instrumentation and dual mobility bearings. This illustrates and reflects the debate that will be at the centre of hip surgery for the next decade.

scholarly journals Does Fluoroscopy Improve Acetabular Component Placement in Total Hip Arthroplasty?

2014 ◽  
Vol 472 (12) ◽  
pp. 3953-3962 ◽  
Author(s):  
Brandon S. Beamer ◽  
Jordan H. Morgan ◽  
Christopher Barr ◽  
Michael J. Weaver ◽  
Mark S. Vrahas
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Component Placement ◽  
Total Hip

scholarly journals A Patient-specific Navigational Template for Precise Acetabular Placement in Unilateral Total Hip Arthroplasty: A Cadaveric Study

2020 ◽  
Author(s):  
Jinlong LIANG ◽  
Xinjian Gao ◽  
Xuewei Fang ◽  
Yonghui Zhao ◽  
Yongqing Xu ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Contralateral Side ◽  
Patient Specific ◽  
Abduction Angle ◽  
Anteversion Angle ◽  
Acetabular Fossa ◽  
Total Hip ◽  
Significant Difference

Abstract Background Total hip arthroplasty (THA) is a widely performed reconstructive surgical intervention. In this paper, we describe a novel patient-specific navigational template to assist in acetabular component implantation in unilateral THA. Methods The template was produced based on data preoperatively acquired with computed tomography (CT) scan. We used the mirror image of the healthy contralateral acetabular anatomical structure to ensure accurate acetabular component implantation in unilateral THA. The surface of the template was designed to conform to the unique contours of the cadaveric acetabular fossa by reverse engineering technology. The orientation of the navigation channel was defined by the acetabular central axis which was determined by the contralateral acetabular centre of rotation, anteversion angle and abduction angle. Each template was formed from acrylate resin by using rapid prototyping (RP) technique. Finally, the template was tested in 20 cadavers scheduled for unilateral THA and postoperative medical imaging was used to evaluate the accuracy and validity of the template. Results During the operation, the acetabular fossa template was easy to obtain in all cases. The abduction angle ( β ) of the cup was (49.9°±4.1°) versus (49.5°±4.7°) on the contralateral side. The anteversion angle (α) of the cup was (17.7° ± 3.1°) versus (18.3°±3.5°) on the contralateral side. In the operative hip, the height of the prosthesis centre(H)was (21.6 mm±2.8 mm) versus (21.9 mm±3.4 mm) in the contralateral side, and the horizontal location of the prosthesis centre(W) was (29.7 mm±3.1 mm) versus (30.90 mm±3.31 mm) in the contralateral side. There was no significant difference in the cup abduction (β) or anteversion (α) angle between the operative and contralateral sides (P=0.7531>0.05 for β and P=0.5996>0.05 for α); In addition, there was no significant difference in the height(H)or horizontal location(W) of the acetabular centre between the operative and contralateral sides (P=0.6494>0.05 for W and P=0.5143>0.05 for H). Conclusion The navigational template is a promising tool for facilitating preoperative planning and intraoperative techniques. With the aid of the template, an acetabular prosthesis can be precisely implanted to the expected position in unilateral THA.

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