Image Guided Navigation System to Measure Intraoperatively Acetabular Implant Alignment

DiGioia, Anthony M.; Jaramaz, Branislav; Blackwell, Mike; Simon, David A.; Morgan, F.; Moody, James E.; Nikou, Constantinos; Colgan, Bruce D.; Aston, Cheryl A.; LaBarca, Richard S.; Kischell, E.; Kanade, Takeo

doi:10.1097/00003086-199810000-00003

Cited by 368 publications

(188 citation statements)

References 35 publications

Supporting

Mentioning

166

Contrasting

Unclassified

Order By: Relevance

“…Also, surgical navigation is usually more timeconsuming. A study reported an additional 10 to 15 minutes of OR time was needed to install the image-guided navigation system [10]. Comparatively, our technique required less than 2 minutes of additional OR time in our study.…”

Section: Discussionmentioning

confidence: 55%

“…Numerous studies have documented surgical navigation holds the promise for providing most accurate intraoperative guidance for acetabular component position [10,16,29,34]. However, the equipment is not available to most surgeons.…”

Section: Discussionmentioning

confidence: 99%

“…Many methods, including visual inspection [32], use of specialized jigs [23], intraoperative fluoroscopic guidance [21], image-free navigation [16,24], and CT-based computer navigation [10,17,27], reportedly assist surgeons in achieving the safe target during the placement of acetabular components. However, all of these techniques have disadvantages, such as a lack of accuracy, high cost, a requirement for special training, and extra preparation and operating room (OR) time.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Intraoperative Radiographs for Placing Acetabular Components in Hip Resurfacing Arthroplasty

Gross

Liu

Webb

2011

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Various clinical and biomechanical studies suggest certain acetabular positions may be associated with higher wear and failure rates in modern metal-on-metal hip resurfacing arthroplasties. However, there are no widely available, reliable, and cost-effective surgical techniques that ensure surgeons are able to place an acetabular component within the safe range of inclination angles after hip resurfacing surgeries. Questions/purposes We investigated the accuracy of intraoperative radiographs to determine the acetabular inclination angle in resurfacing arthroplasty procedures. Patients and Methods The study group included the first 100 resurfacing arthroplasties performed after we started routinely checking the intraoperative acetabular inclination angles. The acetabular component was repositioned if the intraoperative acetabular inclination angle was out of the target range of 30°to 50°. The control group included the previous 100 resurfacing arthroplasties performed without the benefit of intraoperative radiographs. A posterior minimally invasive surgical approach was used in both groups. Demographics and diagnoses were similar in both groups. ResultsThe average (± SD) difference between the intraoperative and 6-week radiographs was 2.7°± 2.5°. The acetabular inclination angles at 6-week followup were within the targeted range more frequently in the study group than in the control group (outliers: 4% versus 29%). Conclusions These data suggest a single intraoperative radiograph is a quick, reliable, and cost-effective method for ensuring the acetabular inclination angle is within the targeted range. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

show abstract

Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Intraoperative Radiographs for Placing Acetabular Components in Hip Resurfacing Arthroplasty

Gross

Liu

Webb

2011

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…Numerous reports suggest the ranges of accuracy with which implants can be placed using computer-assisted surgical navigation typically will have standard deviations of 1°to 10°from the control [5,17,19,23,30,31,43,44,48]. We believe the primary objective of computer-assisted surgery (CAS) is to eliminate unacceptable outliers and we discuss limitations of these prior studies.…”

Section: Introductionmentioning

confidence: 99%

“…The literature documents variable positioning of acetabular cup placement in THA [1,5,10,41]. Extremes of component malpositioning are associated with an increased risk of dislocation and loosening [8,11,16,18,20,42,46].…”

Section: Introductionmentioning

confidence: 99%

Six Sigma Analysis of Minimally Invasive Acetabular Arthroplasty: A Preliminary Investigation

Heck¹,

Stiehl

2009

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Minimally invasive techniques in THA may increase the difficulty of acetabular component insertion relative to the optimized position. We sought to determine the ability of eight surgeons to position an acetabular component placed using an anterior-lateral minimally invasive surgical (MIS) approach with conventional instruments or computer navigation using an optical imageless protocol compared with conventional true values determined by computed tomography (CT). We introduce a new approach, the Six Sigma process capability index, to assess outliers. Using the Six Sigma process capability index (Cp [ 1.3) and the criteria of Lewinnek et al. of ± 10°for adequate precision, three-dimensional (3D) CT was capable for inclination and anteversion. Computer navigation and visual cues with conventional instrumentation were precise for anteversion but not for inclination. We conclude image-free computer navigation was not better than conventional instrumentation with the surgeons' visual cues for acetabular cup placement. Six Sigma analysis allows comparison of various methods of referencing with literature controls, and our data suggest CT referencing is the most precise method.

show abstract

Augmented Reality in Surgery

2004

View full text Add to dashboard Cite

show abstract

Image Guided Navigation System to Measure Intraoperatively Acetabular Implant Alignment

Cited by 368 publications

References 35 publications

Intraoperative Radiographs for Placing Acetabular Components in Hip Resurfacing Arthroplasty

Intraoperative Radiographs for Placing Acetabular Components in Hip Resurfacing Arthroplasty

Six Sigma Analysis of Minimally Invasive Acetabular Arthroplasty: A Preliminary Investigation

Augmented Reality in Surgery

Contact Info

Product

Resources

About