Validation of navigation assisted cup placement in total hip arthroplasty

Abstract

Purpose Computer navigation has the potential to provide precise intraoperative knowledge to the surgeon. Previous studies with navigation have confirmed its function for improved component position but few studies have reported the accuracy and precision of navigation system in clinical use. With this study we propose to evaluate the efficacy of navigation in guiding cup placement. Methods Fifty-six patients undergoing primary total hip arthroplasty were prospectively included in this study. Stryker imageless navigation system which is accurate to 0.5°was used in all cases. Intraoperative data was collected for the acetabular component position using navigation for the freehand cup placement and the final cup placement done using navigation. Postoperative evaluation of component position was done with computed tomography (CT) and the deviation from intraoperative freehand and navigation values were calculated. Results The mean inclination of the freehand reading was 39.5°(range, 20°-58°), mean version of freehand reading was 10.7°(−6°-27°), and the mean navigation reading was 43.2°(37°-49°) for inclination and 13.0°(−8°-24°) for version. On postoperative CT scan analysis the mean inclination was 45.3°(34°-56°) and mean version was 15.1°(4°-25°). The deviation of the freehand inclination from the post operative CT scan reading was 11.4°(1°-30°) and the version deviated by a mean of 10.8°(2°-26°). The deviation of the navigation reading from the CT scan reading had a mean of 5.3°(1°-13°) for inclination and 5.6°( 1°-17°) for version. Conclusion The accuracy of the navigation system over conventional freehand cup placement is validated by this study.

Acetabular cup positioning in revision total hip arthroplasty with Paprosky type III acetabular defects: Martell radiographic analysis

“…On the other hand, Bosker et al [18] showed that the 70.5 % of cups in primary THA were positioned within the safe zone by a freehand technique. In recent studies, improved cup position using computer navigation [21,22] and its accuracy [23] have been reported.…”

Anteroposterior Radiographs Are More Accurate than Cross-Table Lateral Radiographs for Acetabular Anteversion Assessment: A Retrospective Cohort Study

“…Computer-assisted surgery (CAS) has been shown to improve the accuracy and reproducibility of component position compared to manual techniques [7,9,11,20,[22][23][24]. Many CAS systems for THA reference the anterior pelvic plane (APP), a spatial plane defined by bilateral anterior-superior iliac spines (ASIS) and the pubic tubercle, to determine acetabular component anteversion [29].…”

Combining acetabular and femoral morphology improves our understanding of the down syndrome hip

“…While the standing position and the adjustment for pelvic tilt in acetabular parameter measurement are not routinely used in clinical practice, they allow the evaluation of acetabular anatomy without the bias induced by positioning. These parameters would also remain accurate in an operative setting since the surgeon could either use a navigation system (similar to the one used in total hip arthroplasty placement) (Babisch et al, 2008;Kumar et al, 2012) or position the patient such as it is at 0°o f tilt (APPA = 0°) in order to remain concordant with the measurements performed by this system. Acetabular anteversion was found to be significantly smaller in subjects with DS, which is in accordance with previous studies on this patient population (Abousamra et al, 2016;Sankar et al, 2011;Sankar et al, 2012;Woolf and Gross, 2003).…”