Accuracy of Component Positioning in 1980 Total Hip Arthroplasties: A Comparative Analysis by Surgical Technique and Mode of Guidance

Domb, Benjamin G.; Redmond, John M.; Louis, Steven S.; Alden, Kris J.; Daley, Robert J.; LaReau, Justin M.; Petrakos, Alexandra; Gui, Chengcheng; Suárez-Ahedo, Carlos

doi:10.1016/j.arth.2015.06.059

Cited by 122 publications

(128 citation statements)

References 47 publications

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“…Similar results have been published for unicompartmental knee arthroplasty, which is known to be technically more demanding than the TKA [25–27]. Similar results have also been published for acetabular and femoral components of total hip arthroplasty [4, 28]. Most of these studies were performed by experienced surgeons in high volume centres.…”

Section: Teaching With Navigationsupporting

confidence: 73%

Learning navigation – Learning with navigation. A review

Jenny¹,

Picard

2017

SICOT-J

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The goal of this review paper is to retrieve from the existing literature relevant information (1) about the learning curve of the currently existing navigation systems and (2) about the use of navigation system for teaching orthopaedic procedures. All studies reporting on the learning curve of navigation systems support the hypothesis that computer-navigated total knee arthroplasty (TKA) involves only a short learning curve and that beginners can obtain good results from the beginning of their experience, as navigation provides continuous feedback during all phases of the knee replacement surgery and allows for correcting any bone cut errors. Interestingly, there is no comparable research on the learning curve of TKA with standard, manual instrumentation. One might postulate that this learning curve might be longer than with navigation, with potentially a higher rate of outliers. The current literature does support that navigation may be an efficient teaching tool for both experienced orthopaedic surgeons and trainees. Experienced surgeons may improve their skills with conventional techniques and learn new techniques more efficiently and more quickly. Trainees may have a better understanding of the procedure and learn standard techniques with a shorter learning curve. This is probably due to the immediate feedback of navigation systems. A shorter learning curve may be associated with improved clinical and functional results for the patient during this critical period. However, there is no evidence that training with navigation excludes trainees from the need to work in academic environments with experienced teachers. Future techniques in training may include the development of laboratory simulation procedures using navigated feedback.

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Section: Teaching With Navigationsupporting

confidence: 73%

Learning navigation – Learning with navigation. A review

Jenny¹,

Picard

2017

SICOT-J

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“…21 A prospective, randomised, controlled study comparing cup position showed a placement of the acetabular components within the zone suggested by Lewinnek et al 9 of 90% with imageless navigation and 80% with conventional placement (p = 0.661). 15 …”

Section: Component Positioningmentioning

confidence: 97%

What do we get from navigation in primary THA?

et al. 2016

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Navigation in primary total hip arthroplasty has a history of over 20 years. During this process, imageless computer navigation can be particularly helpful in optimally restoring the hip’s biomechanics. This involves the accurate placement of the acetabular component with the determination of the anteversion and abduction, whereby the navigated femur-first technique also allows for a calculation of the combined anteversion. Additional critical parameters such as the reconstruction of the rotation centre, as well as the femoral and acetabular offset, can also be optimally adjusted. Last but not least, an intra-operative evaluation and equalisation of the leg length is possible.Nonetheless, the disadvantages of this surgical technique in terms of the high costs in the acquisition and preservation of the necessary devices, as well as the longer operation time, must be taken into account. However, economic aspects are not the only thing preventing widespread use of the navigation technique. Determining the plane of reference (APP) for the optimal orientation of the implants is based on palpation of the bony landmarks – and this is influenced by the thickness of the soft tissue layer. Furthermore, the experience of the surgeon constitutes a variable that influences the accuracy of navigation.In summary, hip navigation certainly offers an interesting technique for the optimisation of total hip arthroplasty with reconstruction of proper biomechanics. At the same time, there is currently a lack of high-quality randomised controlled long-term trials that evaluate the clinical advantage for the patients, together with cost utility and survival rates.Cite this article: Renner L, Janz V, Perka C, Wassilew GI. What do we get from navigation in primary THA? EFORT Open Rev 2016;1:205-210. 10.1302/2058-5241.1.000034.

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“…46 The TraumaCad software system was used to analyse post-operative radiographs to determine acetabular inclination and anteversion. There was a consistent target for cup positioning of 40⁰ inclination and 20⁰ anteversion throughout the groups.…”

Section: Future Developments In Navigation – the Role Of Roboticsmentioning

confidence: 99%

Computer navigation of the acetabular component in total hip arthroplasty: a narrative review

Davenport

Kavarthapu

2016

EFORT Open Reviews

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Total hip arthroplasty (THA) is a common procedure for primary osteoarthritis, but increasing numbers are also being performed for other pathologies such as secondary arthritis, inflammatory arthropathies and trauma. Estimates suggest that around 8.5 million people in the UK are affected by joint pain secondary to arthritis and a rising ageing population has resulted in an increase in THA operations of around 4% per year over the last six years.Multiple studies have shown that THA provides improved quality of life scores, but there remains the burden of complications which account for 15% of £1bn NHS liability payouts. DaPalma et al analysed the financial impact of complications following THA and found the additional cost of a dislocation within six weeks of surgery is 342% of the primary cost.Following primary THA, complications may occur as a result of incorrect component positioning of the femoral stem, the acetabular cup or both. It is known that acetabular malposition may lead to increased rates of dislocation, impingement, edge-loading, polyethylene wear, pelvic osteolysis and prosthesis failure.Acetabular component positioning has been described as the single most important factor in dictating risk of dislocation following THA. Furthermore, instability and dislocation after primary THA is the most common single reason for revision surgery accounting for 22.5% of all revisions and 33% of acetabular revisions.We outline the currently available methods of acetabular navigation comparing freehand techniques with computer and robotic-assisted navigation of the acetabular component.Cite this article: Davenport D, Kavarthapu V. Computer navigation of the acetabular component in total hip arthroplasty: a narrative review. EFORT Open Rev 2016;1:279-285. DOI: 10.1302/2058-5241.1.000050.

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Accuracy of Component Positioning in 1980 Total Hip Arthroplasties: A Comparative Analysis by Surgical Technique and Mode of Guidance

Cited by 122 publications

References 47 publications

Learning navigation – Learning with navigation. A review

Learning navigation – Learning with navigation. A review

What do we get from navigation in primary THA?

Computer navigation of the acetabular component in total hip arthroplasty: a narrative review

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