Reliable Acetabular Cup Orientation With a New Gravity-Assisted Guidance System

Echeverri, Santiago; Leyvraz, Pierre-François; Zambelli, Pierre‐Yves; Jolles, Brigitte M.

doi:10.1016/j.arth.2005.04.015

Cited by 17 publications

(12 citation statements)

References 32 publications

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“…However, few researchers have investigated the precise location of the hip center of THA performed for patients with DDH . The position and direction of the implanted prosthesis controls the function of the prosthesis and is also associated with the parameters for its life‐span, including gait, recovery of the length of diseased extremity, together with stability, wear, loosening, and osteological lysis . The preoperative planning, templating and the choice of implant should ensure that the rotation center is restored to its pre‐diseased position after total hip replacement .…”

Section: Discussionmentioning

confidence: 99%

Preliminary application of computer‐assisted patient‐specific acetabular navigational template for total hip arthroplasty in adult single development dysplasia of the hip

Zhang

Chen

et al. 2011

Robotics Computer Surgery

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Section: Discussionmentioning

confidence: 99%

Preliminary application of computer‐assisted patient‐specific acetabular navigational template for total hip arthroplasty in adult single development dysplasia of the hip

Zhang

Chen

et al. 2011

Robotics Computer Surgery

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“…It acts as a reference, identifying the initial yaw and roll positions throughout the operation. 17 However, the mechanical bubble level does not show a degree of tilting and could not be calibrated to 0 at any position of the device. Asayama et al used a specially devised goniometer to measure pelvic motion in real time during surgery.…”

Section: Discussionmentioning

confidence: 99%

Use of smartphone to improve acetabular component positioning in total hip athroplasty: A comparative clinical study

Pongkunakorn

Chatmaitri

Diewwattanawiwat

2019

J Orthop Surg (Hong Kong)

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Background: The position of the acetabular cup is important to the outcome of total hip athroplasty (THA). We devised an instrument that uses the level indicator application of smartphone together with a mechanical alignment guide to improve the precision of cup placement. This study aims to determine the percentage of acetabular cups positioned in the Lewinnek safe zone comparing between the conventional technique (using a mechanical alignment guide alone) and the smartphone technique (using a mechanical alignment guide combined with the devised instrument and smartphone). Methods: A historical controlled trial was conducted among 82 patients who underwent primary THAs through a posterolateral approach. In the conventional group, 41 cups were placed during January 2013 and December 2014, whereas 41 cups in the smartphone group were placed during January 2015 and March 2016. Inclination and anteversion angles were measured in standardized pelvic radiographs. The cup orientation was compared between groups. Results: The inclination angle in the smartphone group was significantly lower than in the conventional group (40.9 (SD 3.8) vs. 46.3 (SD 6.7), p < 0.001), but the anteversion angle was higher (19.6 (SD 4.4) vs. 16.5 (SD 6.1), p ¼ 0.010). The smartphone group had more cups positioned in the Lewinnek safe zone (90.2% vs. 56.1%, p ¼ 0.001) and longer operative times (136 (SD 27) vs. 119 (SD 23) min, p ¼ 0.011). No significant difference was found for blood loss (p=¼ 0.384) or dislocation rate (p ¼ 0.494). Conclusion: Using the computerized function of smartphone could improve the precision of cup positioning. Most cups were placed within a narrow margin inside the Lewinnek safe zone.

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“…Computer navigation can increase the percentage of placements in the safe zone (80–96%) 16 compared with conventional insertion (26–71%), 2 whereas 100% within the safe zone can be achieved by robotic-assisted navigation. 17 The percentage of outliers for inclination angle can be significantly minimised by using a bubble level, 3,14,18 a digital protractor, 4 a digital inclinometer or a smartphone with the Angle application. 5,6,19 Our results confirmed similar benefits of a smartphone with the Clinometer application.…”

Section: Discussionmentioning

confidence: 99%

Smartphone-assisted technique in total hip arthroplasty can improve the precision of acetabular cup placement: a randomised controlled trial

2019

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Background: Malposition of the acetabular component mainly results from intraoperative pelvic motion and manual errors during cup placement. We investigated the outcomes of a device that uses a level indicator application of a smartphone to function as a pelvic tilt goniometer to assess intraoperative motion. The cup positions outside Lewinnek’s safe zone were compared between the smartphone-assisted technique and the conventional method that uses a mechanical alignment guide. Methods: A randomised controlled trial was conducted among 64 patients receiving primary cementless total hip arthroplasties (THAs) via a posterolateral approach from June 2015 to February 2017. Acetabular components were implanted either by conventional technique ( n = 32) or using smartphone technique ( n = 32). Inclination and anteversion angles were measured in supine pelvic radiographs. Results: The inclination angle in the smartphone group was not significantly different from the conventional group (41.2° ± 3.9° vs. 40.3° ± 7.9°, p = 0.567). The anteversion angle was also similar (19.3 ± 3.8° vs 19.1° ± 5.9°, p = 0.856). However, the standard deviation of the angle in the smartphone group was significantly lower for inclination ( p < 0.001) and anteversion ( p = 0.016). There were 3 outliers (9.4%) in the smartphone group, but 13 (40.6%) in the conventional group ( p = 0.008). The risk ratio was 0.23 (95% CI, 0.07–0.73). The risk difference was −0.31 (95% CI, –0.51– –0.11). Conclusion: The smartphone-assisted technique in THA improves the precision of cup placement and decreases the percentage of safe zone outliers. Thai Clinical Trials Registry (ID: TCTR20151123002).

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Reliable Acetabular Cup Orientation With a New Gravity-Assisted Guidance System

Cited by 17 publications

References 32 publications

Preliminary application of computer‐assisted patient‐specific acetabular navigational template for total hip arthroplasty in adult single development dysplasia of the hip

Preliminary application of computer‐assisted patient‐specific acetabular navigational template for total hip arthroplasty in adult single development dysplasia of the hip

Use of smartphone to improve acetabular component positioning in total hip athroplasty: A comparative clinical study

Smartphone-assisted technique in total hip arthroplasty can improve the precision of acetabular cup placement: a randomised controlled trial

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