Computerassistierte Hüftpfannennavigation bei primär- und sekundär dysplastischen Ausgangssituationen

Haaker, Rolf; Tiedjen, K. U.; Rubenthaler, F.; Stockheim, M.

doi:10.1055/s-2003-37306

Cited by 30 publications

(3 citation statements)

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“…The clinical results of imageless navigation which we obtained correspond with those of previous in vitro studies. 16,17 CT-based navigation might still have some advantages over the imageless system in patients with abnormal anatomy such as hip dysplasia, post-traumatic deformities or in revision procedures, 22 but this requires further investigation.…”

Section: Discussionmentioning

confidence: 99%

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

Kalteis

Händel

Bäthis

et al. 2006

The Journal of Bone and Joint Surgery. British volume

297

219

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In a prospective randomised clinical study acetabular components were implanted either freehand (n = 30) or using CT-based (n = 30) or imageless navigation (n = 30). The position of the component was determined post-operatively on CT scans of the pelvis. Following conventional freehand placement of the acetabular component, only 14 of the 30 were within the safe zone as defined by Lewinnek et al (40 degrees inclination sd 10 degrees ; 15 degrees anteversion sd 10 degrees ). After computer-assisted navigation 25 of 30 acetabular components (CT-based) and 28 of 30 components (imageless) were positioned within this limit (overall p < 0.001). No significant differences were observed between CT-based and imageless navigation (p = 0.23); both showed a significant reduction in variation of the position of the acetabular component compared with conventional freehand arthroplasty (p < 0.001). The duration of the operation was increased by eight minutes with imageless and by 17 minutes with CT-based navigation. Imageless navigation proved as reliable as that using CT in positioning the acetabular component.

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Section: Discussionmentioning

confidence: 99%

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

Kalteis

Händel

Bäthis

et al. 2006

The Journal of Bone and Joint Surgery. British volume

297

219

View full text Add to dashboard Cite

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“…In retrospective studies, a statistically significant difference in variation for both inclination and anteversion has been found (Haaker et al 2007), and also an advantage in navigation-based cup placement in dysplastic hips (Haaker et al 2003). …”

Section: Discussionmentioning

confidence: 99%

Navigated cup implantation in hip arthroplasty

et al. 2009

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Background and purpose Many studies have suggested that navigation-based implantation can improve cup positioning in total hip arthroplasty (THA). We conducted a systematic review and meta-analysis to compile the best available evidence, and to overcome potential shortcomings because of small sample sizes in individual studies.Methods The search strategy covered the major medical databases from January 1976 through August 2007, as well as various publishers' databases. The internal validity of individual studies was evaluated independently by 3 reviewers. We used random-effects modeling to obtain mean differences in cup angulation and relative risk (RR) of cup positioning outside Lewinnek's safe zone.Results Of 363 citations originally identified, 5 trials of moderate methodology enrolling a total of 400 patients were included in the analysis. Mean cup inclination and anteversion were not statistically significantly different between the conventional groups and the navigated groups. Navigation reduced the variability in cup positioning and the risk of placing the acetabular component beyond the safe zone (RR = 0.21, CI: 0.13–0.32).Interpretation Based on the current literature, navigation is a reliable tool to optimize cup placement, and to minimize outliers. However, long-term outcomes and cost utility analyses are needed before conclusive statements can be drawn about the value of routine navigation in THA.

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“…In vitro study, Jolles et al37) have reported that the accuracy of cup positioning was higher using CT-based navigation than using traditional methods of cup positioning. The usefulness of CT-based navigation has been reported by Sugano et al38) in their study involving patients undergoing THAs with ceramic-on-ceramic bearings and Haaker et al39) who performed cup placement using the navigation system in primary and secondary dysplastic hips.…”

Section: Applications Of Caos In Thamentioning

confidence: 89%

The Evolution of Computer-Assisted Total Hip Arthroplasty and Relevant Applications

et al. 2017

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In total hip arthroplasty (THA), the accurate positioning of implants is the key to achieve a good clinical outcome. Computer-assisted orthopaedic surgery (CAOS) has been developed for more accurate positioning of implants during the THA. There are passive, semi-active, and active systems in CAOS for THA. Navigation is a passive system that only provides information and guidance to the surgeon. There are 3 types of navigation: imageless navigation, computed tomography (CT)-based navigation, and fluoroscopy-based navigation. In imageless navigation system, a new method of registration without the need to register the anterior pelvic plane was introduced. CT-based navigation can be efficiently used for pelvic plane reference, the functional pelvic plane in supine which adjusts anterior pelvic plane sagittal tilt for targeting the cup orientation. Robot-assisted system can be either active or semi-active. The active robotic system performs the preparation for implant positioning as programmed preoperatively. It has been used for only femoral implant cavity preparation. Recently, program for cup positioning was additionally developed. Alternatively, for ease of surgeon acceptance, semi-active robot systems are developed. It was initially applied only for cup positioning. However, with the development of enhanced femoral workflows, this system can now be used to position both cup and stem. Though there have been substantial advancements in computer-assisted THA, its use can still be controversial at present due to the steep learning curve, intraoperative technical issues, high cost and etc. However, in the future, CAOS will certainly enable the surgeon to operate more accurately and lead to improved outcomes in THA as the technology continues to evolve rapidly.

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Computerassistierte Hüftpfannennavigation bei primär- und sekundär dysplastischen Ausgangssituationen

Abstract: The CAS system is helpful even in dysplastic cases. The advantage of three-dimensional preoperative CT-based planning is apparent. The surgeon is not able to plan and realise the ideal cup position in some individual.

Cited by 30 publications

References 0 publications

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

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

Navigated cup implantation in hip arthroplasty

The Evolution of Computer-Assisted Total Hip Arthroplasty and Relevant Applications

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