Navigated cup implantation in hip arthroplasty

Abstract

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.

Application of Rapid Prototyping Pelvic Model for Patients with DDH to Facilitate Arthroplasty Planning: A Pilot Study

“…Intraoperative navigation systems have been used for over a decade. Greater accuracy can be achieved by navigated implantation when compared with traditional manual implantation in respect of cup-positioning [27][28][29][30][31][32][33]. Although a number of application researches on navigated cup implantation have been published, there are inadequate data about patients with DDH.…”

Fluoroscopy assessment during anterior minimally invasive hip replacement is more accurate than with the posterior approach

“…Multiple techniques have been promoted to enhance the accuracy of component positioning, including the use of fluoroscopy [1,2,24], computer navigation [31,32], and robotic assistance [5,6]. Of these three, fluoroscopy is the most widely available and least expensive to adopt.…”

Hinged external fixator placement at the elbow: navigated versus conventional technique

“…The mean AP angulation deviaton in the conventional group was 20. 5 , compared to 15 in the navigated group (p ¼ 0.077).…”

“…Image-assisted navigation based on fluoroscopy has evolved rapidly and has been shown in several studies to increase accuracy and decrease radiation time in general drilling procedures [4][5][6][7]. This technique allows for real-time visualization of the drill bit vector in multiple planes simultaneously.…”