Revision Total Hip Arthroplasty Using Imageless Navigation With the Concept of Combined Anteversion

Chang, Jun-Dong; Kim, In-Sung; Prabhakar, Sharad; Mansukhani, Sameer Ajit; Lee, Sang-Soo; Yoo, Je-Hyun

doi:10.1016/j.arth.2016.12.030

Cited by 18 publications

(14 citation statements)

References 19 publications

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“…Compared with CT-based navigation, the 3D preoperative simulation technology and 3D model had lower accuracy [26–28]. Additionally, previous study reported there was a high accuracy by using imageless navigation-assisted cup positioning [29]. However, in contrast to CT-based navigation technique, the 3D planning was easy to achieve without increasing operative time and extra cost.…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional technology assisted trabecular metal cup and augments positioning in revision total hip arthroplasty with complex acetabular defects

Chen

Lin

et al. 2019

J Orthop Surg Res

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BackgroundRevision total hip arthroplasty (THA) with large acetabular defect remains a challenge. Though trabecular metal (TM) cup and augments have been introduced in defect reconstruction with good result, the accurate positioning of implant is important to avoid complications. Therefore, we aimed to evaluate the usefulness of three-dimensional (3D) simulation and 3D model in assisting implant positioning during complex revision THA.MethodsSixteen patients (18 hips) who underwent revision THA with a Paprosky type III acetabular defect were analyzed retrospectively. Placement of acetabular cup and TM augments was simulated with 3D simulation software and 3D model preoperatively. Cup anteversion, abduction angle, and hip center were measured in each case preoperatively and postoperatively. Primary outcome was the percentage of outliers according to Lewinnek safe zone and Harris hip score (HHS). Secondary outcome was the correlation between the 3D planned and the postoperative value.ResultsThe percentage of outliers was significantly corrected from 77.78% (14/18) preoperatively to 38.88% (7/18) postoperatively (p = 0.04). There was a significant correlation between mean planned cup anteversion and postoperative value (13.39 vs 11.99, r = 0.894; p < 0.001). There was a significant correlation between mean planned abduction and postoperative value (42.67 vs 44.91, r = 0.921, p < 0.001). The number of planned and used augments was the same in all the cases. In 15 cases (83.33%), the size of planned and used TM augments was the same. The HHS was significantly improved at final follow-up (80.94 vs 27.50, p < 0.001). No cases presented dislocation or radiological signs of loosening.ConclusionPreoperative 3D simulation and model were considered the useful method to assist implant positioning in revision THA with complex acetabular defect, with moderate to high accuracy and satisfied clinical outcome.

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Section: Discussionmentioning

confidence: 99%

Three-dimensional technology assisted trabecular metal cup and augments positioning in revision total hip arthroplasty with complex acetabular defects

Chen

Lin

et al. 2019

J Orthop Surg Res

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“…However, Nakamura et al18) and Kuroda et al19) achieved the same accuracy with CT-based navigation for primary and revision THA. Additionally, in a study by Chang et al,20) the optimal cup position was achieved with a very high probability: achievements in radiographic abduction and that in combined anteversion were both 100%. Our study is the first to report the cup position accuracy in CT-based navigation for revision THA in comparison to that in a manual control group.…”

Section: Discussionmentioning

confidence: 93%

Efficacy of Computed Tomography-Based Navigation for Cup Placement in Revision Total Hip Arthroplasty

et al. 2019

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Background Navigation systems are an effective tool to improve the installation accuracy of the cup in primary total hip arthroplasty. This study aimed to evaluate the efficacy of a computed tomography-based navigation system in achieving optimal installation accuracy of implants in revision total hip arthroplasty and to clarify the usefulness of the navigation system. Methods We conducted a retrospective study of 23 hips in 23 patients who underwent revision total hip arthroplasty using a computed tomography-based navigation system; the control group comprised 33 hips in 33 patients who underwent revision total hip arthroplasty without a navigation system. Results The average cup position with the navigation system was 40.0° ± 3.7° in radiographic abduction angle, 18.8° ± 4.8° in radiographic anteversion, and 41.2° ± 8.9° in combined anteversion; without the navigation system, the average cup position was 38.7° ± 6.1°, 19.0° ± 9.1°, and 33.6° ± 20.5°, respectively. The achievement rate of cup positioning within the Lewinnek safe zone was not significantly different between the navigation group (82.6%) and control group (63.6%). In contrast, the achievement rate of cup positioning within the Widmer combined anteversion guidelines was significantly greater in the navigation group (78.3%) than in the control group (48.0%, p = 0.029). Furthermore, outlier cases in the navigation group had a smaller variance of deviation from the optimal cup position than those in the control group did. Conclusions The results show that the use of navigation for revision total hip arthroplasty improved cup positioning and reduced the range of outliers. Improvement of cup placement accuracy influenced the installation of the stem and also improved the achievement rate of combined anteversion. Thus, a computed tomography-based navigation system is very useful for surgeons when placing the cup within the target angle in revision total hip arthroplasty.

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“…2,5 Many scholars have devoted themselves to prolonging the service life of artificial joints in patients undergoing THA by accurately positioning the prosthesis, reducing wear, and reducing the fretting of the prosthesis. 6,7 With the breakthroughs in computer and artificial intelligence technology in recent years, imageless navigation systems have become important in the clinical setting 8 and are now used successfully in total knee arthroplasty, unicompartmental knee arthroplasty, hip arthroplasty, and shoulder arthroplasty. 9 Imageless navigation systems are used to collect anatomic data, calculate the mechanical axis of the limbs, or determine the position of the joint intraoperatively through a three-dimensional optical positioning device and without the use of preoperative or intraoperative images (computed tomography, magnetic resonance imaging, C-arm fluoroscopy, and X-ray images).…”

Section: Introductionmentioning

confidence: 99%

Clinical efficacy of OrthoPilot navigation system versus conventional manual total hip arthroplasty: A systematic review and meta‐analysis

et al. 2019

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Objective This study was performed to compare the clinical efficacy between the OrthoPilot navigation system and conventional manual surgery in patients undergoing total hip arthroplasty. Methods The Embase, PubMed, CINAHL, and Cochrane databases were searched for clinical trials. The outcome measurements were the anteversion angle, inclination angle, and complications. Review Manager 5.3 statistical software was used for the data analysis. Results Significant differences were found in the femoral offset and overall complication rate between the conventional and navigation groups. Additionally, the conventional group had significantly less anteversion than the navigation group. However, the navigation group had significantly better inclination. The operation time was significantly shorter in the conventional than navigation group. Conclusion Both the OrthoPilot navigation system and conventional total hip arthroplasty result in significant improvements in patient function with similar overall complication rates and have their own advantages in achieving good cup position. The conventional procedure has a shorter operation time than does use of a navigation system.

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Revision Total Hip Arthroplasty Using Imageless Navigation With the Concept of Combined Anteversion

Cited by 18 publications

References 19 publications

Three-dimensional technology assisted trabecular metal cup and augments positioning in revision total hip arthroplasty with complex acetabular defects

Three-dimensional technology assisted trabecular metal cup and augments positioning in revision total hip arthroplasty with complex acetabular defects

Efficacy of Computed Tomography-Based Navigation for Cup Placement in Revision Total Hip Arthroplasty

Clinical efficacy of OrthoPilot navigation system versus conventional manual total hip arthroplasty: A systematic review and meta‐analysis

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