Orientation of the acetabular component

Honl, M.; Schwieger, Karsten; Salineros, Matías; Jacobs, Judd; Morlock, Michael M.; Wimmer, Matthias

doi:10.1302/0301-620x.88b10.17587

Cited by 48 publications

(13 citation statements)

References 40 publications

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“…There are 3 types of imaging systems used to simultaneously generate different planes of the target object, all of which need intraoperative registration of anatomical landmarks (Sikorski and Chauhan 2003). Either CT-based, fluoroscopically-assisted, or imageless methods are used to simultaneously generate different planes of the therapeutic object to be treated (Grutzner et al 2004, Widmer and Grutzner 2004, Ottersbach and Haaker 2005, Honl et al 2006, Kalteis et al 2006a). …”

Section: Introductionmentioning

confidence: 99%

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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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Section: Introductionmentioning

confidence: 99%

“…inclination of 40° ± 10°, anteversion of 15° ± 10°) (Lewinnek et al 1978) when using a freehand technique (Saxler et al 2004a, Tannast et al 2005a, Honl et al 2006, Kalteis et al 2006a, Bosker et al 2007, Leichtle et al 2007). …”

Section: Introductionmentioning

confidence: 99%

Navigated cup implantation in hip arthroplasty

et al. 2009

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“…12,13 Honl et al compared acetabular cup orientation between five different computer-assisted navigation systems for total hip arthroplasty and demonstrated significant differences among them. 12 In addition, Carli et al compared the accuracy of intraoperative measurements to postoperative tibial and femoral alignment in two different computer-assisted systems for total knee arthroplasty and found a significant difference in the outcome as well. 13 Interestingly, several clinical studies have demonstrated high accuracy rates of pedicle screw placement using CT-based navigation compared with other methods, such as freehand technique and fluoroscopic navigation.…”

Section: Discussionmentioning

confidence: 99%

Differences between Manufacturers of Computed Tomography–Based Computer-Assisted Surgery Systems Do Exist

Nooh

Lubov

Aoude

et al. 2017

Global Spine Journal

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Study DesignLiterature review.ObjectiveSeveral studies have shown that the accuracy of pedicle screw placement significantly improves with use of computed tomography (CT)-based navigation systems. Yet, there has been no systematic review directly comparing accuracy of pedicle screw placement between different CT-based navigation systems. The objective of this study is to review the results presented in the literature and compare CT-based navigation systems relative only to screw placement accuracy.MethodsData sources included CENTRAL, Medline, PubMed, and Embase databases. Studies included were randomized clinical trials, case series, and case–control trials reporting the accuracy of pedicle screws placement using CT-based navigation. Two independent reviewers extracted the data from the selected studies that met our inclusion criteria. Publications were grouped based on the CT-based navigation system used for pedicle screw placement.ResultsOf the 997 articles we screened, only 26 met all of our inclusion criteria and were included in the final analysis, which showed a significant statistical difference (p < 0.0001, 95% confidence interval 0.92 to 1.23) in accuracy of pedicle screw placement between three different CT-based navigation systems. The mean (weighted) accuracy of pedicle screws placement based on the CT-based navigation system was found to be 97.20 ± 2.1% in StealthStation (Medtronic, United States) and 96.1 ± 3.9% in VectorVision (BrainLab, Germany).ConclusionThis review summarizes results presented in the literature and compares screw placement accuracy using different CT-based navigation systems. Although certain factors such as the extent of the procedure and the experience and skills of the surgeon were not accounted for, the differences in accuracy demonstrated should be considered by spine surgeons and should be validated for effects on patients’ outcome.

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“…At present, computer navigation system seems to be a most reliable tool for cup positioning [8, 10, 26, 27]. However, the use of this system is not widely adopted due to its high costs, complexity and operating time, and individual studies are too small to allow conclusive statements on the potential benefit.…”

Section: Discussionmentioning

confidence: 99%

Acetabular Component Anteversion in Primary and Revision Total Hip Arthroplasty: An Observational Study

Reikerås¹,

Gunderson²

2013

TOORTHJ

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Purpose: In a prospective manner to evaluate the range of acetabular component anteversion actually achieved by the use of a cup positioner in cementless revision and primary THA.Methods: We operated 71 patients with cementless primary THA, and 26 patients with cementless acetabular revision surgery. We aimed to obtain cup anteversion of 10 to 30° with an impactor-positioner. In all cases we used elevated liners and a ceramic head with diameter 28. At 3 months postoperatively the component versions were measured using CT with the patient in supine position.Results: The acetabular component version in the primary hips ranged from 28° of retroversion to 42° of anteversion with a mean of 17.4 ± 14.0°, while the cup version in the revision hips ranged from 4° of retroversion to 32° of anteversion with a mean of 15.0 ± 9.6°(p=0.427). The anteversion of 40 (56%) of the primary acetabular components were within the target zone of 10 to 30°, while 19 (27%) were below the target zone and and 12 (17%) were above the target range. The anteversion of 19 (73%) of the revision acetabular components were within the target zone, while 6 (23%) were below the target zone and 1 (4%) were above the target range. The differences in distribution between the primary and revision operations were not significant (p=0.183).Conclusions: The intraoperative estimation of acetabular anteversion by free hand technique in many cases was not within the intended range of 10 to 30° in either primary or revision THA and with no differences between the two series

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Orientation of the acetabular component

Cited by 48 publications

References 40 publications

Navigated cup implantation in hip arthroplasty

Navigated cup implantation in hip arthroplasty

Differences between Manufacturers of Computed Tomography–Based Computer-Assisted Surgery Systems Do Exist

Acetabular Component Anteversion in Primary and Revision Total Hip Arthroplasty: An Observational Study

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