Fehleinschätzung der Anteversion bei der bildfreien, computerassistierten Hüftpfannen-Navigation als Folge einer vereinfachten Palpationsprozedur der frontalen Beckenebene

Richolt, Jens A.; Rittmeister, M. E.

doi:10.1055/s-2006-933495

Cited by 14 publications

(4 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Such errors can alter perceived anteversion by an average of 8.2°. 35 Furthermore, imageless optical navigation systems require multiple pins to be inserted into bone for spatial tracking throughout surgery. The insertion of these pins can impose additional risk to the patient and include complications such as infection, hematoma, cutaneous nerve injury, and fracture, although it has been demonstrated to be a relatively low-risk procedure with an estimated complication rate of 0.16% per pin site.…”

Section: Discussionmentioning

confidence: 99%

Fluoroscopy Versus Imageless Optical Navigation in Direct Anterior Approach Total Hip Arthroplasty

Manzo,

Lex,

Rodriguez-Elizalde

et al. 2023

J Am Acad Orthop Surg

View full text Add to dashboard Cite

Background: Utilization of the direct anterior approach (DAA) for total hip arthroplasty (THA) has risen in popularity. Accurate implant placement is a critical factor that influences patient outcomes. The goal of this study was to compare the accuracy and precision of fluoroscopy with imageless optical navigation in DAA THA. Methods: This was a cohort study of 640 consecutive primary DAA THAs performed with intraoperative fluoroscopy (n = 300 patients) or imageless optical navigation (n = 304 patients). Accuracy was compared by measuring acetabular cup inclination, anteversion, and leg-length discrepancy (LLD). The proportion of implants placed within the Lewinnek safe zone and those placed within a more precise target of 40 ± 5° inclination and 20 ± 5° anteversion was evaluated. Results: According to the Lewinnek criteria, there was no difference in the percentage of implants placed within both inclination and anteversion targets (fluoroscopy: 90.3%; navigation: 88.8%, P = 0.519). Using the more precise targets, navigation increased the implants positioned correctly for both inclination and anteversion (fluoroscopy: 50.3%; navigation: 65.6%, P < 0.001). Navigation increased the proportion of implants positioned within the target anteversion zone (fluoroscopy: 71.3%; navigation: 83.8%, P < 0.001) but not inclination (fluoroscopy: 71.9%; navigation: 76.9%, P = 0.147). The mean LLD was higher with the use of fluoroscopy compared with navigation (5.5 mm, standard deviation: 4.1; 4.6 mm, SD: 3.4, P < 0.005). No difference in dislocation rate was observed (P = 0.643). Conclusion: Both fluoroscopy and imageless optical navigation demonstrated accurate acetabular implant positioning during DAA THA. Navigation was more precise and associated with improved acetabular anteversion placement and restoration of LLD. Navigation is an accurate alternative to fluoroscopy with decreased radiation exposure.

show abstract

Section: Discussionmentioning

confidence: 99%

Fluoroscopy Versus Imageless Optical Navigation in Direct Anterior Approach Total Hip Arthroplasty

Manzo,

Lex,

Rodriguez-Elizalde

et al. 2023

J Am Acad Orthop Surg

View full text Add to dashboard Cite

show abstract

“…23 In a similar model, Parratte et al 24 were then able to observe that the imageless navigation system is influenced by the thickness of the tissue over the bony APP landmarks. Richolt and Rittmeister 25 demonstrated with the aid of an ultrasound examination that the fatty layer is three times thicker over the symphysis in comparison to the anterior superior iliac spine. In contrast to the anterior superior iliac spine, the fat over the symphysis is not moveable, but can only be compressed by the blunt registration pointer.…”

Section: Component Positioningmentioning

confidence: 99%

What do we get from navigation in primary THA?

et al. 2016

View full text Add to dashboard Cite

Navigation in primary total hip arthroplasty has a history of over 20 years. During this process, imageless computer navigation can be particularly helpful in optimally restoring the hip’s biomechanics. This involves the accurate placement of the acetabular component with the determination of the anteversion and abduction, whereby the navigated femur-first technique also allows for a calculation of the combined anteversion. Additional critical parameters such as the reconstruction of the rotation centre, as well as the femoral and acetabular offset, can also be optimally adjusted. Last but not least, an intra-operative evaluation and equalisation of the leg length is possible.Nonetheless, the disadvantages of this surgical technique in terms of the high costs in the acquisition and preservation of the necessary devices, as well as the longer operation time, must be taken into account. However, economic aspects are not the only thing preventing widespread use of the navigation technique. Determining the plane of reference (APP) for the optimal orientation of the implants is based on palpation of the bony landmarks – and this is influenced by the thickness of the soft tissue layer. Furthermore, the experience of the surgeon constitutes a variable that influences the accuracy of navigation.In summary, hip navigation certainly offers an interesting technique for the optimisation of total hip arthroplasty with reconstruction of proper biomechanics. At the same time, there is currently a lack of high-quality randomised controlled long-term trials that evaluate the clinical advantage for the patients, together with cost utility and survival rates.Cite this article: Renner L, Janz V, Perka C, Wassilew GI. What do we get from navigation in primary THA? EFORT Open Rev 2016;1:205-210. 10.1302/2058-5241.1.000034.

show abstract

“…Another possibility is to determine the position of the pelvis by palpation of bony landmarks, either with a navigated pointer or a digitizing arm . The disadvantage of this method is that the accuracy of palpation relies on the experience of the clinician, and it may give misleading results in obese patients . The pelvic angle has also been assessed cinematically by recording the trajectories of skin‐affixed markers during gait and predefined motion .…”

mentioning

confidence: 99%

“…6 The disadvantage of this method is that the accuracy of palpation relies on the experience of the clinician, and it may give misleading results in obese patients. 7 The pelvic angle has also been assessed cinematically by recording the trajectories of skin-affixed markers during gait 8 and predefined motion. 9 However, the practical importance of kinematic measurements remains debatable, as some authors suggest a satisfactory correlation between the position of the pelvis at standing and during gait.…”

mentioning

confidence: 99%

Application of Navigated Ultrasound for Assessment of the Anterior Pelvic Plane in Patients With Degenerative Hip Diseases

Kochman¹,

Goral

Martín³

et al. 2017

J Ultrasound Med

View full text Add to dashboard Cite

show abstract

Fehleinschätzung der Anteversion bei der bildfreien, computerassistierten Hüftpfannen-Navigation als Folge einer vereinfachten Palpationsprozedur der frontalen Beckenebene

Cited by 14 publications

References 10 publications

Fluoroscopy Versus Imageless Optical Navigation in Direct Anterior Approach Total Hip Arthroplasty

Fluoroscopy Versus Imageless Optical Navigation in Direct Anterior Approach Total Hip Arthroplasty

What do we get from navigation in primary THA?

Application of Navigated Ultrasound for Assessment of the Anterior Pelvic Plane in Patients With Degenerative Hip Diseases

Contact Info

Product

Resources

About