Role of Navigation in Total Hip Arthroplasty

Kelley, Todd C.; Swank, Michael

doi:10.2106/jbjs.h.01463

Cited by 52 publications

(39 citation statements)

References 21 publications

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“…The first hip navigation system was developed in 1992. The system requires a preoperative CT scan and registration of anatomic landmarks so the computer can determine where the pelvis lies in space [19]. There has been criticism of the navigation systems including the extra costs, additional radiation exposure, time-consuming preoperative planning, and intraoperative matching procedures [34].…”

Section: Discussionmentioning

confidence: 99%

Acetabular Component Positioning Using Anatomic Landmarks of the Acetabulum

Yoo

Lee

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background The acetabular cup should be properly oriented to prevent dislocation and to reduce wear. However, achieving proper cup placement is challenging with potentially large variations of cup position. We propose a new technique to position the acetabular cup. Questions/Purposes We used this technique, then determined actual cup position and subsequent dislocation rate. Methods We measured acetabular abduction (a°) and anteversion (b°) on preoperative CT scans in 46 patients (50 hips) scheduled for THA. During the operation, we identified the transverse acetabular notch (TAN) and anterior acetabular notch (AAN), a notch at the anterior acetabular margin. We then marked two reference points for 40°abduction at the acetabular rim: the superior point, which is opposite the TAN, and the inferior point at |a À 40| mm inside (when a was [ 40°) or outside the TAN (when a was \ 40°). We also marked two reference points for 15°anteversion: the posterior point opposite the AAN and the anterior point at |b À 15| mm inside (when b was \ 15°) or outside the AAN (when b was [ 15°). During cup insertion, we aligned cup abduction to the line between the superior and inferior points and cup anteversion to the line between the anterior and posterior points. We measured cup abduction and anteversion and evaluated the dislocation rate. One patient was lost to followup before 60 months; the minimum followup for the other 45 patients was 60 months (mean, 62.8 months; range, 60-65 months). Results The mean cup abduction was 40°(range, 32°-47°) and the mean cup anteversion was 17°(range, 8°-25°). No dislocation occurred postoperatively in 49 hips (45 patients) for a minimum of 5 years followup.

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Section: Discussionmentioning

confidence: 99%

Acetabular Component Positioning Using Anatomic Landmarks of the Acetabulum

Yoo

Lee

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…9 However, it has only been used in normal or primary osteoarthritic hips. [10][11][12][13] It may not be applicable to hips with severe deformity secondary to developmental dysplasia or congenital dislocation. In addition, the TAL is difficult to visualise intraoperatively.…”

mentioning

confidence: 99%

Using the Transverse Acetabular Ligament as a Landmark for Acetabular Anteversion: An Intraoperative Measurement

Inoue

Majima

Abe

et al. 2013

J Orthop Surg (Hong Kong)

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purpose. To measure the transverse acetabular ligament (TAL) anteversion in hips with severe deformity, using fluoroscopy-computed tomographic navigation. Methods. 31 hips in 10 men and 19 women aged 40 to 78 (mean, 58.7) years who underwent total hip arthroplasty for primary osteoarthritis (n=6) or osteoarthritis secondary to developmental hip dysplasia (n=19) or congenital hip dislocation (n=6) were included. The severity of hip dislocation was classified according to the Crowe classification; 15 hips were grade 1, 7 were grade 2, 3 were grade 3, and 6 were grade 4. The TAL anteversion was measured using fluoroscopy-computed tomographic navigation. The difference in TAL anteversion between non-dislocated hips (Crowe grade 1, n=15) and dislocated hips (Crowe grades 2-4, n=16) was compared. results. In all 31 hips, the TAL could be visualised intra-operatively. No patient reported severe pain, Using the transverse acetabular ligament as a landmark for acetabular anteversion: an intraoperative measurement early wear, loosening, or dislocation after 2 years. The mean TAL anteversion and inclination angles measured by the navigation system were 26.5º (SD, 8.9º; range, and 41.5º (SD, 4.6º; range, 32º-49º), respectively. 22 of the 31 hips were in the safe zone. TAL anteversion in non-dislocated and dislocated hips was not significantly different. Interand intra-observer mean absolute differences in TAL anteversion were 0.3º and 0.4º, respectively. conclusion. The TAL is a useful anatomic landmark for total hip arthroplasty in dislocated hips.

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“…The position of the acetabular component affects the results of total hip arthroplasty (THA) in terms of 16 postoperative range of motion, dislocation, impingement, wear and osteolysis, and is also associated with 17 long-term implant survival [1][2][3][4]. Precise positioning of the acetabular components in the normal native 18 acetabulum also decreases shearing force on the component, and is thought to be ideal from a biomechanical viewpoint [4,5].…”

mentioning

confidence: 99%

“…Modification of the operative procedures and breakthroughs in implant 20 technology have made it possible to perform THA even in patients with severe deformities. However, it is 21 very difficult to place the acetabular component in the appropriate position in cases with severe acetabular 22 deformity either freehand or with a mechanical device because of the difficulty of identifying the 23 orientation around the acetabulum [3,6,7]. Although various navigation systems, including imageless, …”

mentioning

confidence: 99%

Does Degree of the Pelvic Deformity Affect the Accuracy of Computed Tomography-Based Hip Navigation?

Kajino¹,

Kabata²,

Maeda³

et al. 2012

The Journal of Arthroplasty

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Abstract:Some navigation systems have been used for improvement of component positioning, there have been few reports regarding cases of severe pelvic deformity. We performed a retrospective review of 25 cases of THA with a computed tomography (CT)-based navigation system in patients with severe pelvic deformities and estimated acetabular component position and angle between severe deformity group and mild dysplastic group as a control. There were no significant differences in accuracy of navigation system between two groups in terms of three-dimensional component position or angle. Accuracy of CT-based hip navigation does not depend on the degree of pelvic deformity, and this system is also useful to identify acetabular orientation and for precise component implantation in cases of pelvic deformity. Keywords:total hip arthroplasty, pelvic deformity, computed tomography (CT)-based navigation system, acetabular component, developmental dysplasia. Brief title:Hip Navigation in Severe Pelvic Deformity mild dysplastic group as a control. There were no significant differences in accuracy of navigation system 10 between two groups in terms of three-dimensional component position or angle. Accuracy of CT-based 11 hip navigation does not depend on the degree of pelvic deformity, and this system is also useful to 12 identify acetabular orientation and for precise component implantation in cases of pelvic deformity.

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Role of Navigation in Total Hip Arthroplasty

Cited by 52 publications

References 21 publications

Acetabular Component Positioning Using Anatomic Landmarks of the Acetabulum

Acetabular Component Positioning Using Anatomic Landmarks of the Acetabulum

Using the Transverse Acetabular Ligament as a Landmark for Acetabular Anteversion: An Intraoperative Measurement

Does Degree of the Pelvic Deformity Affect the Accuracy of Computed Tomography-Based Hip Navigation?

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