Post-operative Virtual Range of Motion in Robotic-assisted THA Patients to determine Pre-operative Simulation Needs

For preoperative simulations of hip range of motion to be useful in predicting complications after total hip arthroplasty (THA), the factors that could affect post-operative function must be considered including, but not limited to, bony impingement, pelvic position, and implanted vs. planned differences. This study retrospectively simulates ranges of motion to prosthetic and bony impingement of THA patients with known planned and implanted component positions and pelvic tilt to determine the factors and needs to accurately simulate range of motion preoperatively.Twenty-two (22) anterolateral, cementless total hip arthroplasties were performed using robotic-arm assisted technology which allowed capture of the implanted stem version and position in addition to robotic-assisted cup placement to plan. With the known implanted positions and preoperative 3-dimentional (3D) bone models, six (6) hip maneuvers were virtually simulated in custom software. Correlations were evaluated between planned and implanted component positions, pelvic tilt, ranges of motion, and patient-reported outcomes.Average ranges of motion to impingement were similar to those of previous simulation and navigation studies. Supine tilt varied from -10 ̊ (posterior) to 15 ̊ (anterior) with an average of 3.4±6.6 ̊. Very little correlation was seen between native or planned stem version and implanted stem version. Correlations were seen between some maneuvers such as internal rotation (IR) at 90 degrees flexion (F) (IR@90F) and combined component version and pelvic tilt. Bony impingement occurred during IR@90F in 9 of the 22cases. Pelvic tilt assessment, bony impingement detection, better prediction of implanted component position or the ability to execute a plan, such as robotically, would all provide a more accurate pre-operative simulation of the post-operative patient’s function.

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Consideration of pelvic tilt at the time of preoperative planning improves standing acetabular position after robotic-arm assisted total hip arthroplasty

Hip International ◽

10.1177/11207000211038670 ◽

2021 ◽

pp. 112070002110386

Author(s):

Matthew S Hepinstall ◽

Gloria Coden ◽

Hytham S Salem ◽

Brandon Naylor ◽

Chelsea Matzko ◽

...

Keyword(s):

Acetabular Component ◽

Pelvic Tilt ◽

3 Dimensional ◽

Total Hip ◽

Hip Anatomy ◽

Pelvic Position ◽

Planning Group ◽

Hip Arthroplasties ◽

Safe Zones ◽

Cup Position

Introduction: Approximately half of dislocating total hip arthroplasties (THAs) demonstrate acetabular component position within traditional safe zones. It is unclear if postoperative functional acetabular position can be reliably improved by considering preoperative pelvic tilt. We investigated whether standing cup position targets could be more accurately achieved by considering preoperative standing pelvic tilt in addition to bone landmarks when planning for robot-assisted THA. Methods: We reviewed 146 THAs performed by a single surgeon using computed tomography-based 3-dimensional planning and robotic technology to guide acetabular reaming and component insertion. Planning for 73 consecutive cases started at 40° of inclination and 22° of anteversion relative to the supine functional plane and was adjusted to better match native hip anatomy. Planning for the next 73 cases was modified to consider standing pelvic position based on standing preoperative radiographs. We compared groups to determine the rate when cups were placed outside our standing targets of 15–30° anteversion and 35–50° inclination. Results: Cup position proved to be reliable in both groups, with 83% of cups in the anatomic planning cohort and 90% of cups in the functional planning cohort achieving standing targets for both anteversion and inclination ( p = 0.227). Variances were lower in the functional planning group: 9.4° versus 15.8° of inclination ( p = 0.079) and 18.3° versus 26.1° of anteversion ( p = 0.352). The range of functional positions was narrower in the functional planning group: 35.7–47.5° versus 31.8–54.9° of inclination and 16.7–35.0° versus 10.1–35.9° of anteversion. Discussion: Our results suggest enhanced planning that considers pelvic tilt, when coupled to a precision tool to achieve the plan, can reliably achieve target standing component positions. Considering preoperative functional pelvic position may improve postoperative functional acetabular component placement in THA, but the clinical benefit of this has yet to be confirmed.

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Smart trail with camera and inertial measurement unit for intraoperative estimation of hip range of motion in total hip replacement surgery

2015 IEEE Biomedical Circuits and Systems Conference (BioCAS) ◽

10.1109/biocas.2015.7348383 ◽

2015 ◽

Author(s):

Shaojie Su ◽

Jiyang Gao ◽

Zhe Cao ◽

Hong Chen ◽

Zhihua Wang

Keyword(s):

Range Of Motion ◽

Total Hip Replacement ◽

Hip Replacement ◽

Inertial Measurement Unit ◽

Measurement Unit ◽

Inertial Measurement ◽

Total Hip ◽

Replacement Surgery ◽

Hip Replacement Surgery ◽

Hip Range Of Motion

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Parallel Adaptive Estimation of Hip Range of Motion for Total Hip Replacement Surgery

IEICE Transactions on Information and Systems ◽

10.1093/ietisy/e90-1.1.30 ◽

2007 ◽

Vol E90-D (1) ◽

pp. 30-39 ◽

Cited By ~ 1

Author(s):

Y. KAWASAKI ◽

F. INO ◽

Y. SATO ◽

S. TAMURA ◽

K. HAGIHARA

Keyword(s):

Range Of Motion ◽

Total Hip Replacement ◽

Hip Replacement ◽

Adaptive Estimation ◽

Total Hip ◽

Replacement Surgery ◽

Hip Replacement Surgery ◽

Hip Range Of Motion

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Anatomical Hip Range of Motion After Implantation During Total Hip Arthroplasty With a Large Change in Pelvic Inclination

The Journal of Arthroplasty ◽

10.1016/j.arth.2012.03.002 ◽

2012 ◽

Vol 27 (9) ◽

pp. 1641-1650.e1 ◽

Cited By ~ 29

Author(s):

Hidenobu Miki ◽

Takayuki Kyo ◽

Nobuhiko Sugano

Keyword(s):

Total Hip Arthroplasty ◽

Range Of Motion ◽

Hip Arthroplasty ◽

Large Change ◽

Total Hip ◽

Pelvic Inclination ◽

Hip Range Of Motion

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Bony impingement affects range of motion after total hip arthroplasty: A subject-specific approach

Journal of Orthopaedic Research® ◽

10.1002/jor.20541 ◽

2007 ◽

Vol 26 (4) ◽

pp. 443-452 ◽

Cited By ~ 41

Author(s):

Oliver Kessler ◽

Shantanu Patil ◽

Wirth Stefan ◽

Eckart Mayr ◽

Clifford W. Colwell ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Range Of Motion ◽

Hip Arthroplasty ◽

Specific Approach ◽

Total Hip ◽

Bony Impingement ◽

Subject Specific

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Influence of body mass index on sagittal hip range of motion and gait speed recovery six months after total hip arthroplasty

International Orthopaedics ◽

10.1007/s00264-018-4250-y ◽

2019 ◽

Vol 43 (11) ◽

pp. 2447-2455 ◽

Cited By ~ 3

Author(s):

Pierre Martz ◽

Abderrahmane Bourredjem ◽

Jean Francis Maillefert ◽

Christine Binquet ◽

Emmanuel Baulot ◽

...

Keyword(s):

Body Mass Index ◽

Total Hip Arthroplasty ◽

Range Of Motion ◽

Body Mass ◽

Hip Arthroplasty ◽

Gait Speed ◽

Total Hip ◽

Hip Range Of Motion

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Reliability of hip range of motion measurement among experienced arthroscopic hip preservation surgeons

Journal of Hip Preservation Surgery ◽

10.1093/jhps/hnz062 ◽

2019 ◽

Vol 7 (1) ◽

pp. 77-84 ◽

Cited By ~ 1

Author(s):

Joshua D Harris ◽

Richard C Mather ◽

Shane J Nho ◽

John P Salvo ◽

Allston J Stubbs ◽

...

Keyword(s):

Range Of Motion ◽

Pelvic Tilt ◽

External Rotation ◽

Level Of Evidence ◽

Motion Measurement ◽

Hip Range Of Motion ◽

Asymptomatic Volunteers ◽

Hip Flexion ◽

Hip Internal Rotation ◽

Intra Class Correlation Coefficient

Abstract The aim of this study was to determine (i) the reliability of hip range of motion measurement among experienced arthroscopic hip preservation surgeons and (ii) the magnitude of hip flexion change with posterior pelvic tilt. Five experienced arthroscopic hip preservation surgeons (5–18 years of hip surgery experience) performed passive hip range of motion (internal and external rotation), flexion (contralateral hip extended) and flexion with posterior pelvic tilt (contralateral hip maximally flexed) on five young healthy asymptomatic volunteers (three males, two females; 34.4 ± 10.7 years of age). Motion was measured via digital photography and goniometry. Inter-observer reliability was calculated via two-way mixed, single measures, intra-class correlation coefficient. Paired t-test was utilized to compare hip flexion (with contralateral hip extended) to hip flexion with posterior pelvic tilt (with contralateral hip in forced flexion). The reliabilities of measurements of hip flexion with posterior pelvic tilt and external rotation were excellent, that of hip flexion was fair, and that of hip internal rotation was poor. The magnitude of hip flexion increase with posterior pelvic tilt was 17.0° ± 3.0° (P < 0.001). The reliability of hip range of motion measurement by five experienced arthroscopic hip preservation surgeons was excellent for measures of hip flexion with posterior pelvic tilt and external rotation. Contralateral maximal hip flexion significantly increased ipsilateral hip flexion (approximately 17°). Level of Evidence: Diagnostic, level III (without consistently applied reference standard)

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