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.

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.

Validation of a Simple, Laser-Guided System for Prescribing Acetabular Cup Inclination Angle in Total Hip Arthroplasty

2009 ◽  
Author(s):  
Jennifer Peter ◽  
Jovauna M. Currey ◽  
Meir Marmor ◽  
Jenni M. Buckley ◽  
William McGann
Keyword(s):  
Clinical Trials ◽  
Total Hip Arthroplasty ◽  
Inclination Angle ◽  
Hip Arthroplasty ◽  
Navigation Systems ◽  
Acetabular Cup ◽  
Steep Learning Curve ◽  
Total Hip ◽  
Acetabular Orientation ◽  
Accuracy And Repeatability

In total hip arthroplasty (THR) cases, it can be technically challenging to achieve the correct inclination angle for the acetabular component. Commercial intra-operative navigation systems have been successfully used to precisely guide acetabular orientation [1]; however, these systems are costly, time consuming, and have a steep learning curve for new users [2]. In an effort to simplify the procedure, McGann et al. have developed a laser-guided system to address the inclination angle [3]. In preliminary clinical trials, this system has been used successfully, but its accuracy and repeatability have never been quantified.

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 >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 >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.

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 Low rate of early periprosthetic fractures in cementless short-stem total hip arthroplasty using a minimally invasive anterolateral approach

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Matthias Luger ◽  
Günter Hipmair ◽  
Clemens Schopper ◽  
Bernhard Schauer ◽  
Rainer Hochgatterer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Hip Arthroplasty ◽  
Minimally Invasive ◽  
Hip Arthroplasty ◽  
Supine Position ◽  
Short Stem ◽  
Anterolateral Approach ◽  
Total Hip ◽  
Asa Score ◽  
Short Stems

Abstract Purpose Minimally invasive (MIS) approaches in combination with short stems have gained popularity in recent years in total hip arthroplasty (THA). A decreased risk for periprosthetic femoral fractures (PFFs) is reported for cementless short-stem THA, but in contrast to other approaches, the risk factors for PFFs for short-stem THA using MIS anterolateral approach in supine position are not described in literature. Methods A single-center consecutive series of 1052 hips in 982 patients, performed between 2014 and 2019 with a short curved stem and a press fit using an MIS anterolateral approach in supine position, was retrospectively screened for inclusion. Fourteen patients were lost to follow-up. Therefore, 1038 THAs in 968 patients were included. Risk factors for intra- and postoperative PFFs within 90 days were analyzed. We investigated for sex, age, body mass index (BMI), diagnosis, and laterality. Results In total, 18 PFFs (1.7%) occurred. Intraoperative fracture occurred in ten cases ( 0.9%), with another eight cases (0.8%) occurring postoperatively. Increased American Society of Anesthesiologists (ASA) Score was a significant risk factor for PFF (p = 0.026), whereas sex (p = 0.155), age (p = 0.161), BMI (p = 0.996), and laterality (p = 1.000) were not. Seven PFFs (0.7%) required revision arthroplasty. Conclusion Cementless short-stem THA using the MIS anterolateral approach is a procedure with a low number of PFFs within 90 days from index surgery. Fracture rates are comparable to other MIS approaches, and comparable femoral short stems are used. Age, sex, and BMI were not identified as risk factors of PFF, while risk for PFF increased with ASA Score. Level of Evidence Level IV

scholarly journals Usefulness of Intraoperative C-Arm Image Intensifier in Reducing Errors of Acetabular Component During Primary Total Hip Arthroplasty: An Application of Widmer’s Method

2021 ◽  
Author(s):  
Joo-Hyoun Song ◽  
Yong-Sik Kim ◽  
Soon-Yong Kwon ◽  
Young-Wook Lim ◽  
Jiyoung Jung ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Intraoperative Imaging ◽  
Harris Hip Score ◽  
Acetabular Cup ◽  
Target Zone ◽  
Total Hip ◽  
3D Computed Tomography

Abstract Background: Acetabular prosthesis positioning in total hip arthroplasty (THA) is crucial in reducing the risk of dislocation. There has been minimal research on the proper way to put the acetabular components into the safe zone intraoperatively. Assessment of version by intraoperative imaging intensifier is very valuable. The value of Widmer’s method, using the intraoperative C-arm available to determine cup anteversion was assessed.Methods: 101 hips in 91 patients who underwent primary THA were eligible for inclusion. Utilizing intraoperative C-arm images, measurement was performed using the technique described by Widmer. The values obtained using 3D computed tomography postoperatively, which determined the anteversion of the acetabular component, were regarded as the reference standard.Results: The method of Widmer obtained values similar to those obtained using 3D computed tomography and was considered accurate (n.s.). All 101 hips were positioned in the set target zone. Among the 101 hips, the cup position in nine hips (8.9%) was changed. The dislocation rate in our study was 1.0% with all dislocations occurring in hips placed in the target zone. The mean Harris hip score after THA in one year was 94.2 (82-98).Conclusions: The method of Widmer was accurate using intraoperative imaging intensifier for the measurement of the anteversion of the acetabular component during THA, with reference to the anteversion obtained from the 3D computed tomography. Also, utilizing intraoperative C-arm imaging was very useful because it allowed for correction of the position of the acetabular cup.

Sign in / Sign up

Export Citation Format

Share Document