Initial Results of an Acetabular Center Axis Registration Technique in Navigated Hip Arthroplasty with Deformed Acetabular Rims

BackgroundIn cementless total hip arthroplasty, imageless computer-assisted navigation is usually used to register the anterior pelvic plane (APP). The accuracy of this method is influenced by the subcutaneous tissues overlying the registration landmarks. On the other hand, the acetabular center axis (ACA) is determined from the acetabular rim. Precise registration of the ACA is possible because of direct palpation using a pointer. Imageless navigation using the ACA usually targets patients with normal acetabular morphology. The aim of this study was to investigate the accuracy of imageless navigation using the ACA instead of the APP in patients with normal or deformed acetabular rims.MethodsThe intraoperative cup position was compared with that obtained from the postoperative computed tomography (CT) images in 18 cases.ResultsThe inclination angle derived from the navigation system was 3.4 ± 5.3 degrees smaller and the anteversion angle was 1.4 ± 3.1 degrees larger than those derived from the CT images.ConclusionThe inclination cup angle of the navigation system was significantly inferior to the true value, particularly in cases with large anterior osteophytes.

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Clinical Validation of Computer-Assisted Navigation in Total Hip Arthroplasty

Advances in Orthopedics ◽

10.4061/2011/171783 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Eric Beaumont ◽

Pierre Beaumont ◽

Daniel Odermat ◽

Isabelle Fontaine ◽

Herbert Jansen ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Navigation System ◽

Ct Scans ◽

Computer Assisted ◽

Clinical Validation ◽

Clinical Validity ◽

Assisted Navigation ◽

Total Hip ◽

Secondary Objective

A CT-based navigation system is helpful to evaluate the reamer shaft and the impactor position/orientation during unilateral total hip arthroplasty (THA). The main objective of this study is to determine the accuracy of the Navitrack system by measuring the implant's true anteversion and inclination, based on pre- and postoperative CT scans (n=9patients). The secondary objective is to evaluate the clinical validity of measurements based on postop anteroposterior (AP) radiographs for determining the cup orientation. Postop CT-scan reconstructions and postop planar radiographs showed no significant differences in orientation compared to peroperative angles, suggesting a clinical validity of the system. Postoperative AP radiographs normally used in clinic are acceptable to determine the cup orientation, and small angular errors may originate from the patient position on the table.

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Accuracy of Imageless Computer Assisted Navigation System through in Total Hip Arthroplasty in vitro and in vivo Studies

World Congress on Medical Physics and Biomedical Engineering 2006 - IFMBE Proceedings ◽

10.1007/978-3-540-36841-0_771 ◽

2007 ◽

pp. 3044-3047 ◽

Cited By ~ 1

Author(s):

D. Lim ◽

F. Lin ◽

R. Wixson ◽

R. Hendrix ◽

M. MacDonald ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Navigation System ◽

In Vivo Studies ◽

Computer Assisted ◽

Assisted Navigation ◽

Total Hip

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Periacetabular osteotomy using an imageless computer-assisted navigation system: a new surgical technique

Journal of Hip Preservation Surgery ◽

10.1093/jhps/hnz058 ◽

2019 ◽

Vol 6 (4) ◽

pp. 426-431

Author(s):

Jessica M Hooper ◽

Rachel R Mays ◽

Lazaros A Poultsides ◽

Pablo G Castaneda ◽

Jeffrey M Muir ◽

...

Keyword(s):

Surgical Technique ◽

Navigation System ◽

Periacetabular Osteotomy ◽

Weight Bearing ◽

Computer Assisted ◽

Joint Stability ◽

Modified Technique ◽

Assisted Navigation ◽

Acetabular Fragment ◽

Imageless Navigation

Abstract Periacetabular osteotomy (PAO) is an effective surgical treatment for hip dysplasia. The goal of PAO is to reorient the acetabulum to improve joint stability, lessen contact stresses and slow the development of hip arthrosis. During PAO, the acetabulum is repositioned to adequately cover the femoral head. PAO preserves the weight-bearing posterior column of the pelvis, maintains the acetabular blood supply and retains the hip abductor musculature. The surgical technique needed to perform PAO is technically demanding, with correct repositioning of the acetabulum the most important—and challenging—aspect of the procedure. Imageless navigation has proven useful in other technically challenging surgeries, although its use in PAO has not yet been investigated. We have modified the standard technique for PAO to include the use of an imageless navigation system to confirm acetabular fragment position following osteotomy. Here, we describe the surgical technique and discuss the potential of this modified technique to improve patient-related outcomes.

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