scholarly journals Intraoperative measurement of acetabular component position using imageless navigation during revision total hip arthroplasty

2021 ◽  
Vol 64 (4) ◽  
pp. E442-E448
Author(s):  
Xin Yu Mei ◽  
Ali Etemad-Rezaie ◽  
Oleg A. Safir ◽  
Allan E. Gross ◽  
Paul R. Kuzyk
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Radiographic Measurement ◽  
Absolute Difference ◽  
Total Hip ◽  
Ct Measurements ◽  
Imageless Navigation ◽  
Revision Tha ◽  
Cup Position

Background: Acetabular component malposition is a major cause of dislocation following total hip arthroplasty (THA). Intellijoint HIP is an imageless navigation tool that has been shown to provide accurate intraoperative measurement of cup position during primary THA without substantially increasing operative time. However, its accuracy in revision THA has not been evaluated. This study therefore aims to assess the accuracy of Intellijoint HIP in measuring cup inclination and anteversion in comparison with computed tomography (CT) during revision THA. Methods: Intellijoint HIP was used to measure the position of the preexisting cup in 53 consecutive patients undergoing revision THA between December 2018 and February 2020. Two authors blinded to the intraoperative navigation measurements also independently measured cup position using preoperative CT according to Murray’s radiographic definitions. Pearson correlation coefficients with 95% confidence intervals (CIs), paired t tests and Bland–Altman plots were used to assess agreement between navigation- and CT-measured cup position. Statistical analysis was performed using GraphPad Prism, with p values less than 0.05 indicating statistical significance. Results: There was excellent agreement between navigation and CT measurements for both cup inclination (r = 0.89, 95% CI 0.81–0.93) and anteversion (r = 0.93, 95% CI 0.88–0.96), with the mean absolute difference being 5.2º (standard deviation [SD] 4.0º) for inclination and 4.8º (SD 5.4º) for anteversion. The navigation measurement was within 10º of the radiographic measurement in 47 of 53 (88.7%) cases for inclination and 46 of 53 (86.8%) cases for anteversion. Conclusion: Imageless navigation demonstrated excellent correlation and agreement with CT measurements for both inclination and anteversion over a wide range of acetabular component positions.

Imageless navigation for insertion of the acetabular component in total hip arthroplasty

2006 ◽  
Vol 88-B (2) ◽  
pp. 163-167 ◽  
Author(s):  
T. Kalteis ◽  
M. Handel ◽  
H. Bäthis ◽  
L. Perlick ◽  
M. Tingart ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Imageless Navigation

New Cross-Table Lateral Radiography Method for Measuring Acetabular Component Anteversion in Total Hip Arthroplasty: A Prospective Study of 93 Primary THA

2017 ◽  
Vol 27 (3) ◽  
pp. 293-298 ◽  
Author(s):  
Hajime Seo ◽  
Masatoshi Naito ◽  
Yoshinari Nakamura ◽  
Koichi Kinoshita ◽  
Tomohiro Nomura ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Interobserver Reliability ◽  
Reliability And Validity ◽  
Plain Radiography ◽  
New Method ◽  
Total Hip ◽  
Ct Measurements ◽  
A Prospective Study

Introduction Various methods have been described for measuring acetabular component anteversion. However, accurate measurement of anteversion is difficult. We herein propose a new method using cross-table lateral (CL) radiography performed with the contralateral hip flexed to 45° (45° flexed CL radiography). The main purpose of this study was to evaluate the reliability and validity of this new method. Methods The study group included 93 patients who underwent total hip arthroplasty (THA). All hips were evaluated with computed tomography (CT) and both standard and 45° flexed CL radiographs to measure acetabular component anteversion the week after THA. The intraobserver and interobserver reliability of each measurement was assessed. Plain radiography measurements were compared with reference CT measurements to evaluate their validity. Results All measurements had excellent intraobserver and interobserver reliability, and plain radiography measurements correlated well with CT measurements. The mean measurements were 21.9° (3°-39°) with CT, 24.9° (7°-47°; p<0.001) with standard CL radiographs, and 22.5° (7°-43°; p = 0.112) with 45° flexed CL radiographs. Discussion The anteversion values measured with our new method were closer to the CT values used as a reference standard than those with standard CL radiographs. Our new method appears to be reliable and valid for measuring acetabular component anteversion.

Revision total hip arthroplasty using the Kerboull acetabular reinforcement device for Paprosky type III defects involving the inferior margin of the acetabulum

2018 ◽  
Vol 100-B (6) ◽  
pp. 725-732 ◽  
Author(s):  
E. Gibon ◽  
N. Barut ◽  
J-P. Courpied ◽  
M. Hamadouche
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Revision Total Hip Arthroplasty ◽  
Inferior Margin ◽  
Total Hip ◽  
Type Iii ◽  
Revision Tha ◽  
Reinforcement Device

Aims The purpose of this retrospective study was to evaluate the minimum five-year outcome of revision total hip arthroplasty (THA) using the Kerboull acetabular reinforcement device (KARD) in patients with Paprosky type III acetabular defects and destruction of the inferior margin of the acetabulum. Patients and Methods We identified 36 patients (37 hips) who underwent revision THA under these circumstances using the KARD, fresh frozen allograft femoral heads, and reconstruction of the inferior margin of the acetabulum. The Merle d’Aubigné system was used for clinical assessment. Serial anteroposterior pelvic radiographs were used to assess migration of the acetabular component. Results At a mean follow-up of 8.2 years (5 to 19.3), the mean Merle d’Aubigné score increased from 12.5 (5 to 18) preoperatively to 16.5 (10 to 18) (p < 0.0001). The survival rate at ten years was 95.3% (sd 4.5; 95% confidence interval (CI) 86.4 to 100) and 76.5% (sd 9.9, 95% CI 57.0 to 95.9) using aseptic loosening and radiological loosening as the endpoints, respectively. Conclusion These results show that the use of the KARD with reconstruction of the inferior margin of the acetabulum in revision THA is associated with acceptable clinical results and survival at mid-term follow-up with, however, a high rate of migration of the acetabular component of 21.6%. Cite this article: Bone Joint J 2018;100-B:725–32.

A Deep Learning Tool for Automated Radiographic Measurement of Acetabular Component Inclination and Version After Total Hip Arthroplasty

2021 ◽  
Author(s):  
Pouria Rouzrokh ◽  
Cody C. Wyles ◽  
Kenneth A. Philbrick ◽  
Taghi Ramazanian ◽  
Alexander D. Weston ◽  
...  
Keyword(s):  
Deep Learning ◽  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Radiographic Measurement ◽  
Learning Tool ◽  
Total Hip

Improving Acetabular Component Positioning in Total Hip Arthroplasty: A Cadaveric Study of an Inertial Navigation Tool and a Novel Registration Method

2021 ◽  
pp. 155633162110517
Author(s):  
Jobe Shatrov ◽  
Daniel Marsden-Jones ◽  
Matt Lyons ◽  
William L. Walter
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Lateral Position ◽  
Cadaveric Study ◽  
Anatomical Landmarks ◽  
Registration Method ◽  
Total Hip ◽  
Cup Positioning ◽  
Cup Position

Background: Incorrect acetabular component positioning in total hip arthroplasty (THA) has been associated with poor outcomes. Computer-assisted hip arthroplasty increases accuracy and consistency of cup positioning compared to conventional methods. Traditional navigation units have been associated with problems such as bulkiness of equipment and reproducibility of anatomical landmarks, particularly in obese patients or the lateral position. Purpose: We sought to evaluate the accuracy of a novel miniature inertial measurement system, the Navbit Sprint navigation device (Navbit, Sydney, Australia), to navigate acetabular component positioning in both the supine and lateral decubitus positions. We also aimed to validate a new method of patient registration that does not require acquisition of anatomical landmarks for navigation. Methods: We performed THA in a cadaveric study in supine and lateral positions using Navbit navigation to record cup position and compared mean scores from 3 Navbit devices for each cup position on post-implantation CT scans. Results: A total of 11 cups (5 supine and 6 lateral) were available for comparison. A difference of 2.34° in the supine direct anterior approach when assessing acetabular version was deemed to be statistically but not clinically significant. There was no statistically significant difference between CT and navigation measurements of cup position in the lateral position. Conclusion: This cadaveric study suggests that a novel inertial-based navigation tool is accurate for cup positioning in THA in the supine and lateral positions. Furthermore, it validates a novel registration method that does not require the identification of anatomical landmarks.

Measuring leg length and offset with an imageless navigation system during total hip arthroplasty: is it really accurate?

2009 ◽  
Vol 5 (2) ◽  
pp. 192-197 ◽  
Author(s):  
Tobias Renkawitz ◽  
Tibor Schuster ◽  
Thomas Herold ◽  
Holger Goessmann ◽  
Ernst Sendtner ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Navigation System ◽  
Leg Length ◽  
Total Hip ◽  
Imageless Navigation

Biomechanical analysis of transverse acetabular fracture fixation in the elderly via the posterior versus the anterior approach with and without a total hip arthroplasty

2020 ◽  
Vol 234 (9) ◽  
pp. 966-974
Author(s):  
Joel Moktar ◽  
Alan Machin ◽  
Habiba Bougherara ◽  
Emil H Schemitsch ◽  
Radovan Zdero
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Acetabular Fracture ◽  
Anterior Approach ◽  
Posterior Approach ◽  
Failure Load ◽  
The Elderly ◽  
Clinical Failure ◽  
Total Hip

This study provides the first biomechanical comparison of the fixation constructs that can be created to treat transverse acetabular fractures when using the “gold-standard” posterior versus the anterior approach with and without a total hip arthroplasty in the elderly. Synthetic hemipelvises partially simulating osteoporosis (n = 24) were osteotomized to create a transverse acetabular fracture and then repaired using plates/screws, lag screws, and total hip arthroplasty acetabular components in one of four ways: posterior approach (n = 6), posterior approach plus a total hip arthroplasty acetabular component (n = 6), anterior approach (n = 6), and anterior approach plus a total hip arthroplasty acetabular component (n = 6). All specimens were biomechanically tested. No differences existed between groups for stiffness (range, 324.6–387.3 N/mm, p = 0.629), clinical failure load at 5 mm of femoral head displacement (range, 1630.1–2203.9 N, p = 0.072), or interfragmentary gapping (range, 0.67–1.33 mm, p = 0.359). Adding a total hip arthroplasty acetabular component increased ultimate mechanical failure load for posterior (2904.4 vs. 3652.3 N, p = 0.005) and anterior (3204.9 vs. 4396.0 N, p = 0.000) approaches. Adding a total hip arthroplasty acetabular component also substantially reduced interfragmentary sliding for posterior (3.08 vs. 0.50 mm, p = 0.002) and anterior (2.17 vs. 0.29 mm, p = 0.024) approaches. Consequently, the anterior approach with a total hip arthroplasty may provide the best biomechanical stability for elderly patients, since this fixation group had the highest mechanical failure load and least interfragmentary sliding, while providing equivalent stiffness, clinical failure load, and gapping compared to other surgical options.

Radiolucent lines do not affect the longevity of highly cross-linked polyethylene cemented components in total hip arthroplasty

2021 ◽  
Vol 103-B (10) ◽  
pp. 1604-1610
Author(s):  
Yusuke Takaoka ◽  
Koji Goto ◽  
Jiro Tamura ◽  
Yaichiro Okuzu ◽  
Toshiyuki Kawai ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Long Term Outcome ◽  
Total Hip ◽  
Radiolucent Lines ◽  
Kaplan Meier ◽  
Acetabular Components

Aims We aimed to evaluate the long-term outcome of highly cross-linked polyethylene (HXLPE) cemented acetabular components and assess whether any radiolucent lines (RLLs) which arose were progressive. Methods We retrospectively reviewed 170 patients who underwent 187 total hip arthroplasties at two hospitals with a minimum follow-up of ten years. All interventions were performed using the same combination of HXLPE cemented acetabular components with femoral stems made of titanium alloy. Kaplan-Meier survival analysis was performed for the primary endpoint of acetabular component revision surgery for any reason and secondary endpoint of the appearance of RLLs. RLLs that had appeared once were observed over time. We statistically assessed potential relationships between RLLs and a number of factors, including the technique of femoral head autografting and the Japanese Orthopaedic Association score. Results The mean follow-up period was 13.0 years (10.0 to 16.3). Femoral head autografting was performed on 135 hips (72.2%). One acetabular component was retrieved because of deep infection. No revision was performed for the aseptic acetabular loosening. The Kaplan-Meier survival curve for the primary and secondary endpoints were 98.2% (95% confidence interval (CI) 88.6% to 99.8%) and 79.3% (95% CI 72.8% to 84.6%), respectively. RLLs were detected in 38 hips (21.2%), at a mean of 1.7 years (1 month to 6 years) postoperatively. None of the RLLs were progressive, and the presence of RLLs did not show a significant association with the survival and clinical score. RLLs were more frequently observed in hips without femoral head autografts than in those with autografts. Conclusion The use of HXLPE cemented acetabular components in total hip arthroplasty demonstrated excellent clinical outcomes after ten years, and no RLLs were progressive, and their presence did not affect the outcome. Femoral head autografting did not negatively impact the acetabular component survival or the appearance of RLLs. Cite this article: Bone Joint J 2021;103-B(10):1604–1610.

Fate of the Retained Acetabular Component During Revision Total Hip Arthroplasty: A Meta-Analysis and Systematic Review

2020 ◽  
Vol 35 (4) ◽  
pp. 1130-1136
Author(s):  
Muhammad Hanif ◽  
Chongyan Wang ◽  
Chin Tat Lim ◽  
Syed Shahid Noor
Keyword(s):  
Systematic Review ◽  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Meta Analysis ◽  
Revision Total Hip Arthroplasty ◽  
Total Hip
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