Accuracy of acetabular cup placement using CT-based navigation in total hip arthroplasty: Comparison between obese and non-obese patients

Imai, Norio; Takubo, Ryota; Suzuki, Hayato; Shimada, Hayato; Miyasaka, Dai; Tsuchiya, Kazuki; Endo, Naoto

doi:10.1016/j.jos.2018.11.007

Cited by 18 publications

(16 citation statements)

References 19 publications

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“…Second, the power value of a ≥ 5° implantation error in both radiographic inclination and radiographic anteversion simultaneously was 0.72 according to the unpaired t-test while a desirable power value was at least 0.8. However, we could evaluate the soft-tissue thickness with high reliability with a high ICC value of > 0.9, similar to previous studies [9,16,28,29,30]. Moreover, according to our ndings, the surgeons could predict the risk of a ≥ 5° implantation error by the CT images taken before surgery.…”

Section: Discussionsupporting

confidence: 83%

“…However, HipCOMPASS has the advantage of being inexpensive compared to CT-based navigation systems. The accuracy of cup alignment placed using HipCOMPASS was approximately 3° (Suda et al, 2016); it is slightly inferior to the accuracy of 2° obtained by CT-based navigation systems (Imai et al, 2019); although, it is su ciently acceptable.…”

Section: Discussionmentioning

confidence: 70%

“…It is well-known that obesity is one of the risk factors of dislocation due to the malpositioning of the acetabular component [5,6]. It was previously reported that THA with a CT-based navigation system was not affected by obesity, even though patients' BMIs were ≥ 30 kg/m 2 [16].…”

Section: Discussionmentioning

confidence: 97%

“…The CT scans were examined in patients 1 week after THA for postoperative evaluation of the positioning of both the acetabular and femoral components using ZedHip® software (Lexi, Tokyo, Japan) [13,14,15]. The cup-placement angle was evaluated using the ZedHip postoperative evaluation system as described previously [16]. In this system, the contour of the 3D pelvic model, created from preoperative CT data, was automatically superimposed on a 3D pelvic model created from postoperative CT data, so that the postoperative cup radiographic inclination and anteversion relative to the preoperative functional pelvic plane could be determined.…”

Section: Measurements Of the Alignment Of The Acetabular Componentmentioning

confidence: 99%

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Accuracy of acetabular cup implantation, as a function of body mass index and soft-tissue thickness, with a mechanical intraoperative support device: A retrospective observational study

Suzuki

Imai

Hirano

et al. 2020

Preprint

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Background HipCOMPASS, a mechanical intraoperative support device used in total hip arthroplasty (THA), improves the cup-alignment accuracy. However, alignment accuracy in obese patients has not been examined. We aimed to compare the cup-alignment accuracy, using HipCOMPASS, between patients with and without obesity. Methods We retrospectively evaluated 448 consecutive patients who underwent primary THA using HipCOMPASS. We measured the soft-tissue thickness of the anterior-superior iliac spine (ASIS) and pubic symphysis using preoperative computed tomography (CT) images and the difference in cup angle pre- and postoperatively based on the cup-alignment error on CT. We used Pearson coefficients to determine the correlation of body mass index (BMI) and soft-tissue thickness with cup-alignment error. We created receiver operating characteristic (ROC) curves to determine the cutoff value for statistically significant cup-alignment error factors in radiographic inclination and anteversion of ≥ 5°. Results There were significant correlations between the absolute value of radiographic anteversion difference and BMI (r = 0.205), ASIS thickness (r = 0.419), and pubic symphysis thickness (r = 0.434). The absolute value of radiographic inclination difference was significantly correlated with ASIS (r = 0.257) and pubic symphysis thickness (r = 0.202). The ROC curve showed a pubic symphysis thickness of 37.2 mm for a ≥ 5° implantation error in both radiographic inclination and anteversion simultaneously. The cup-alignment error for HipCOMPASS was large in patients whose pubic symphysis thickness was ≥ 37.2 mm on preoperative CT. Conclusion We recommend using methods other than HipCOMPASS, including computed tomography-based navigation systems, in obese patients.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 97%

Section: Measurements Of the Alignment Of The Acetabular Componentmentioning

confidence: 99%

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Accuracy of acetabular cup implantation, as a function of body mass index and soft-tissue thickness, with a mechanical intraoperative support device: A retrospective observational study

Suzuki

Imai

Hirano

et al. 2020

Preprint

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“…Most of the intraoperative assistance systems of total hip arthroplasty (THA) or pelvis osteotomy, such as the computed tomography (CT)-based imageless navigation system [12, 13] or a mechanical support device [14], refer to the anterior pelvic plane (APP) or functional pelvic plane, which was the APPA in supine position [15]. If DDH patients tilted their pelvis anteriorly to increase the bony coverage of the femoral head [4], the degree of anterior tilt of the pelvis may be dependent on the anterior center-edge angle (ACE), posterior CE angle (PCE), lateral CE angle (LCE), and acetabular anteversion (AA) (operative anteversion of Murray’s definition [16]).…”

Section: Introductionmentioning

confidence: 99%

Correlation of tilt of the anterior pelvic plane angle with anatomical pelvic tilt and morphological configuration of the acetabulum in patients with developmental dysplasia of the hip: a cross-sectional study

et al. 2019

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Background It was previously reported that pelvises with developmental dysplasia of the hip are tilted anteriorly, which increases bony coverage of the femoral head. This study aimed to investigate the correlation between anatomical parameters of the pelvis such as pelvic incidence and anatomical pelvic tilt and functional parameters of the spine and pelvis such as tilt of the anterior pelvic plane. Methods We examined 84 female patients with bilateral developmental dysplasia of the hip who had undergone curved periacetabular osteotomy at author’s institution. Radiographs of the thoracic to lumbar spines and the pelvis were obtained in the standing position to measure spino-pelvic parameters before surgery. Morphological parameters of the acetabulum such as the anterior center-edge (CE) angle, posterior CE angle, lateral CE angle, and acetabular anteversion were measured using a preoperative three-dimensional pelvic model reconstructed from computed tomography images. Pearson’s correlation analysis was conducted to evaluate the relationship of these parameters. Results With regard to correlations between pelvic incidence (PI) and other parameters, the sacral slope (SS) value (r = 0.666) was the highest among functional parameters and the anatomical-SS value (r = 0.789) was the highest among morphological parameters. There were moderate correlations of the anterior pelvic plane angle (APPA) with pelvic tilt (PT) (r = − 0.594) and anatomical-PT (r = 0.646). With regard to correlations between spino-pelvic parameters and bony morphological parameters of the acetabulum, there was a moderate correlation between anatomical-PT and acetabular anteversion (AA) (r = 0.424). There were moderate correlations of APPA with the anterior CE angle (r = − 0.478), posterior CE angle (r = 0.432), and AA (r = 0.565). APPA had a stronger correlation with anatomical-PT (r = 0.646) than with AA. Conclusions The tilt of the pelvis may be more dependent on anatomical-PT, a morphological parameter of the pelvis, than the lateral CE angle, anterior CE angle, posterior CE angle, and acetabular anteversion on bony coverage of the acetabulum. This study is the first to investigate the correlation between functional parameters of the pelvis and spine and morphological parameters of the pelvis and acetabulum besides PI.

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A propensity score-matched comparison between Mako robotic arm-assisted system and conventional technique in total hip arthroplasty for patients with osteoarthritis secondary to developmental dysplasia of the hip

Sato

Okuda

et al. 2022

Arch Orthop Trauma Surg

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Accuracy of acetabular cup placement using CT-based navigation in total hip arthroplasty: Comparison between obese and non-obese patients

Cited by 18 publications

References 19 publications

Accuracy of acetabular cup implantation, as a function of body mass index and soft-tissue thickness, with a mechanical intraoperative support device: A retrospective observational study

Accuracy of acetabular cup implantation, as a function of body mass index and soft-tissue thickness, with a mechanical intraoperative support device: A retrospective observational study

Correlation of tilt of the anterior pelvic plane angle with anatomical pelvic tilt and morphological configuration of the acetabulum in patients with developmental dysplasia of the hip: a cross-sectional study

A propensity score-matched comparison between Mako robotic arm-assisted system and conventional technique in total hip arthroplasty for patients with osteoarthritis secondary to developmental dysplasia of the hip

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