Leg Length Discrepancy in Computer Navigated Total Hip Arthroplasty – How Accurate are We?

Ellapparadja, Pregash; Mahajan, Vivek; Atiya, Sami; Sankar, B.; Deep, Kamal

doi:10.5301/hipint.5000368

Cited by 35 publications

(24 citation statements)

References 25 publications

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“…Finally, 6 trials involving 779 patients were included. 6,17–21 The patients’ characteristics and conditions in the included studies were compared (sex, age, and baseline characteristics), but no statistically significant differences were found. The literature screening process and the results are shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

Clinical efficacy of OrthoPilot navigation system versus conventional manual total hip arthroplasty: A systematic review and meta‐analysis

et al. 2019

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Objective This study was performed to compare the clinical efficacy between the OrthoPilot navigation system and conventional manual surgery in patients undergoing total hip arthroplasty. Methods The Embase, PubMed, CINAHL, and Cochrane databases were searched for clinical trials. The outcome measurements were the anteversion angle, inclination angle, and complications. Review Manager 5.3 statistical software was used for the data analysis. Results Significant differences were found in the femoral offset and overall complication rate between the conventional and navigation groups. Additionally, the conventional group had significantly less anteversion than the navigation group. However, the navigation group had significantly better inclination. The operation time was significantly shorter in the conventional than navigation group. Conclusion Both the OrthoPilot navigation system and conventional total hip arthroplasty result in significant improvements in patient function with similar overall complication rates and have their own advantages in achieving good cup position. The conventional procedure has a shorter operation time than does use of a navigation system.

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Section: Resultsmentioning

confidence: 99%

Clinical efficacy of OrthoPilot navigation system versus conventional manual total hip arthroplasty: A systematic review and meta‐analysis

et al. 2019

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“…A second limitation of this study was the lack of a control group with ‘enhanced’ femoral workflow, or the lack of head‐to‐head comparisons with other methods; however, the accuracy of the measurement of LLD and CO with other robotic or non‐robotic systems have been widely described in the literature 6,20,21 . Finally, the main limitation of this study was the inaccuracy of using plain radiographs to assess the LLD and CO, though radiographs have been consistently used as a gold standard for pelvic biomechanical parameter measurement.…”

Section: Discussionmentioning

confidence: 99%

“…In a case series of 76 hips, Dastane et al 19 were able to reproduce LLD ≤6 mm in 99% of their patients using an imageless navigation system. Ellapparadja et al 20 reported that with computer navigation, the LLDs were restored within 6 mm in 146 patients (96.05%), while only six patients (3.94%) had LLD >6 mm.…”

Section: Discussionmentioning

confidence: 99%

Precision and accuracy of robot‐assisted technology with simplified express femoral workflow in measuring leg length and offset in total hip arthroplasty

Lepri

Villano

Innocenti

et al. 2020

Robotics Computer Surgery

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Background: Semi-active robot-assisted total hip arthroplasty (THA) has two options to measure the leg length discrepancy (LLD) and combined offset (CO), the 'enhanced' femoral workflow and the so-called 'express' simplified workflow. The purpose of this study was to determine the precision and accuracy of intraoperative LLD and CO measurement with express workflow robotic THA. Methods: Between February 2018 and December 2019, 30 patients underwent an express workflow robot-assisted primary THA for intraoperative LLD and CO measurements. Postoperative radiographs were used for LLD and CO measurement. In order to examine the accuracy of the robotic system assessment, the absolute difference between the robotic assessments and radiographic evaluations was calculated. Results: Intraoperative robotic measurements reported a mean error of 0.2-0.6 mm for each registration, with no significant difference between them (p ¼ 0.311). The average absolute discrepancies between the robotic and radiographic assessments in the LLD and CO measurements were 1.3 � 1.5 mm (p ¼ 0.17) and 1.1 � 0.9 mm (p ¼ 0.11), respectively, while the Pearson's correlation coefficients were 0.69 and 0.71. Conclusions: An external marker without a femoral array inserted into a screw positioned in the greater trochanter would be an easier and faster method to measure LLD and CO. Our study showed that the measured values of LLD and CO obtained by intraoperative express workflow robot-assisted THA system were precise and accurate.

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“…Also, this method has derived a variety of other methods for measuring the positional relationship between the pelvis and the femur. Computer-navigated surgery based on these methods can generally achieve an LLD value within 5 mm [18].…”

Section: Introductionmentioning

confidence: 99%

Calculation method to predict postoperative limb length in patients undergoing THA following developmental dysplasia of hips

Guo¹,

Chen²,

Zhang³

et al. 2019

BMC Musculoskelet Disord

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BackgroundLimb length discrepancy (LLD) is one of the main cause of dissatisfaction after total hip arthroplasty (THA). The teardrop-lesser trochanter method can accurately predict and analyze LLD for healthy people. However, for patients with preoperative LLD, no method for predicting postoperative LLD is currently available, and these patients are highly susceptible to more severe LLD after THA. Accordingly, this study proposed a calculation method to predict postoperative limb length for these patients.MethodsEighty patients who underwent THA between May 2016 and October 2018 due to unilateral developmental dysplasia of the hip (DDH) were evaluated. Relevant parameters were measured from radiographs of full-length lower limbs, e.g. the distance between the rotation center of the hip and the midpoint of the tibial plafond and the distance between the point which was marked at the same height as the lesser trochanter on the anatomical long axis of the femur and the midpoint of the tibial plafond. Then, a mathematical model was established by simplifying the structure from the hip to the ankle. The relationship between the placement position of the prosthesis and the LLD value was calculated by Law of Sines and Iterative Calculation.ResultsThe preoperatively predicted LLD values and the postoperatively measured LLD values were compared, yielding a mean absolute difference of 3.7 (range, 0.1 to 8.6) mm. The intraclass correlation coefficient (ICC) of the two parameters exhibited strong reliability (ICC = 0.911, 95%CI, 0.795 to 0.955). The Bland-Altman plot also showed good conformity between the two parameters.ConclusionsThe proposed calculation method effectively predicted the postoperative LLD using preoperative parameters. Despite the complexity of the method, it can go a long way towards reducing the occurrence of severe postoperative LLD in DDH-THA.

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Leg Length Discrepancy in Computer Navigated Total Hip Arthroplasty – How Accurate are We?

Abstract: Based on our results we conclude that computer navigation is an excellent tool to facilitate the successful reproduction of leg length in THA.

Cited by 35 publications

References 25 publications

Clinical efficacy of OrthoPilot navigation system versus conventional manual total hip arthroplasty: A systematic review and meta‐analysis

Clinical efficacy of OrthoPilot navigation system versus conventional manual total hip arthroplasty: A systematic review and meta‐analysis

Precision and accuracy of robot‐assisted technology with simplified express femoral workflow in measuring leg length and offset in total hip arthroplasty

Calculation method to predict postoperative limb length in patients undergoing THA following developmental dysplasia of hips

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