Accuracy of Cup Positioning With the Computed Tomography-Based Two-dimensional to Three-Dimensional Matched Navigation System: A Prospective, Randomized Controlled Study

Yamada, Kazuki; Endo, Hidenori; Tetsunaga, Tomonori; Miyake, Takamasa; Sanki, Tomoaki; Ozaki, Toshifumi

doi:10.1016/j.arth.2017.08.001

Cited by 35 publications

(31 citation statements)

References 34 publications

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“…Inadequate orientation of the acetabular component is associated with postoperative impingement [1], dislocation [2], accelerated polyethylene wear [3], liner damage, and restricted range of motion [4]. Surgeons use intraoperative navigation systems to improve the accuracy of implant orientation [5][6][7]. Computed tomography (CT)-based navigation systems that match preoperative images with the actual pelvis use different techniques.…”

Section: Introductionmentioning

confidence: 99%

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An accelerometer-based navigation system provides acetabular cup orientation accuracy comparable to that of computed tomography-based navigation during total hip arthroplasty in the supine position

et al. 2020

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Background: Inadequate acetabular component orientation is associated with postoperative impingement, dislocation, and accelerated polyethylene wear. Computed tomography (CT)-based navigation systems provide accuracy for total hip arthroplasty (THA) but are not available in all facilities. Accelerometer-based navigation systems are inexpensive, but their accuracy remains undetermined. This study compares the accuracy of cup orientation in THA using CT-based and accelerometer-based navigation systems. Methods: This retrospective study included 35 consecutive patients (11 males, 24 females; mean age, 65 years) who underwent primary cementless THA via an anterolateral approach in the supine position. Both CT-based and accelerometer-based navigation systems were used simultaneously. The accuracy of cup orientation was compared between the two systems using postoperative CT. Results: The accuracy of cup inclination was 2.7°± 2.0°in the CT-based group and 3.3°± 2.4°in the accelerometer-based group. The accuracy of cup anteversion was 2.8°± 2.6°in the CT-based group and 3.4°± 2.2°in the accelerometer-based group. No significant difference was observed in cup inclination (p = 0.29) or cup anteversion (p = 0.34) between CT-based and accelerometer-based navigation. Conclusions: The accuracy of cup positioning did not differ significantly between CT-based and accelerometer-based navigation systems.

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Section: Introductionmentioning

confidence: 99%

“…2D-3D matching requires radiation exposure because multidirectional fluoroscopic images must be matched with 3D pelvic images reconstructed from preoperative CT data. Paired-point matching navigation is not very accurate in patients with severe deformities [5]. In addition, not all institutions have expensive CT-based navigation systems.…”

Section: Introductionmentioning

confidence: 99%

An accelerometer-based navigation system provides acetabular cup orientation accuracy comparable to that of computed tomography-based navigation during total hip arthroplasty in the supine position

et al. 2020

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“…As no differences between robot-assisted and freehand THA were observed in this study, future work may also consider the use of computer navigation systems as these are less costintensive, when compared with robotic arm-assisted THA, and several studies in the literature have demonstrated that computer navigation systems improve component placement. [30][31][32][33] In conclusion, our study suggests that the robot-assisted THA has the potential utility in restoring the native hip geometry with higher accuracy and repeatability than the freehand THA technique. However, as the magnitude of asymmetry in kinematic parameters in all three anatomical planes was comparable between robot-assisted and freehand THA patient groups, this study suggests that, while both robot-assisted and freehand THA have the potential to improve gait symmetry, no differences in gait symmetry at 1-year follow-up existed between both groups.…”

Section: Discussionmentioning

confidence: 62%

“…Lastly, as in vivo kinematics are influenced by multiple factors including patient, implant, and surgical factors, and the sample size for the freehand THA group is small, further study is needed to further elucidate the influences of these parameters on the robotic arm–assisted THA procedure in terms of in vivo kinematics. As no differences between robot‐assisted and freehand THA were observed in this study, future work may also consider the use of computer navigation systems as these are less cost‐intensive, when compared with robotic arm–assisted THA, and several studies in the literature have demonstrated that computer navigation systems improve component placement …”

Section: Discussionmentioning

confidence: 81%

In vivo kinematic analysis of patients with robotic‐assisted total hip arthroplasty during gait at 1‐year follow‐up

Peng

Arauz

Desai

et al. 2019

Robotics Computer Surgery

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Background Suboptimal component positioning has been suggested as an important contributing factor to postoperative gait asymmetry. The aim of this study is to determine whether robotic arm–assisted THA better restores gait symmetry than freehand THA. Methods Component orientation and positioning parameters and in vivo gait kinematics were quantified for implanted and native hips in 20 robotic arm–assisted and eight freehand THA patients, using a validated combined three‐dimensional modeling technique. Results Although neither THA procedure fully restored the native hip geometry, the robotic arm–assisted THA showed a better accuracy than freehand THA, with lower root mean square errors of component orientations. Gait asymmetry was not fully eliminated by either robotic arm–assisted or freehand THA, with increased internal rotation most notably observed in the implanted hip. Conclusion Improved accuracy in restoring native hip geometry achieved by the robotic arm–assisted THA procedure did not fully translate into improved gait symmetry.

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“…However, 3D printing technology cannot reveal the structure of soft tissue, blood vessels, and nerves in a lesion area. Surgical navigation systems and surgical robots provide strong support for the implementation of precision surgery, but the high associated costs, the lack of force feedback, and the tedious training process limit their use.…”

Section: Introductionmentioning

confidence: 99%

Mixed Reality Combined with Three‐Dimensional Printing Technology in Total Hip Arthroplasty: An Updated Review with a Preliminary Case Presentation

Lei

Kong

et al. 2019

Orthopaedic Surgery

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Three‐dimensional (3D) printing technology, virtual reality, and augmented reality technology have been used to help surgeons to complete complex total hip arthroplasty, while their respective shortcomings limit their further application. With the development of technology, mixed reality (MR) technology has been applied to improve the success rate of complicated hip arthroplasty because of its unique advantages. We presented a case of a 59‐year‐old man with an intertrochanteric fracture in the left femur, who had received a prior left hip fusion. After admission to our hospital, a left total hip arthroplasty was performed on the patient using a combination of MR technology and 3D printing technology. Before surgery, 3D reconstruction of a certain bony landmark exposed in the surgical area was first performed. Then a veneer part was designed according to the bony landmark and connected to a reference registration landmark outside the body through a connecting rod. After that, the series of parts were made into a holistic reference registration instrument using 3D printing technology, and the patient's data for bone and surrounding tissue, along with digital 3D information of the reference registration instrument, were imported into the head‐mounted display (HMD). During the operation, the disinfected reference registration instrument was installed on the selected bony landmark, and then the automatic real‐time registration was realized by HMD through recognizing the registration landmark on the reference registration instrument, whereby the patient's virtual bone and other anatomical structures were quickly and accurately superimposed on the real body of the patient. To the best of our knowledge, this is the first report to use MR combined with 3D printing technology in total hip arthroplasty.

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Accuracy of Cup Positioning With the Computed Tomography-Based Two-dimensional to Three-Dimensional Matched Navigation System: A Prospective, Randomized Controlled Study

Abstract: The accuracy of cup positioning in CT-based 2D-3D matched navigation was better than in paired-point matched navigation, and was not affected by patient factors. It is a useful system for even severely deformed pelvises such as developmental dysplasia of the hips.

Cited by 35 publications

References 34 publications

An accelerometer-based navigation system provides acetabular cup orientation accuracy comparable to that of computed tomography-based navigation during total hip arthroplasty in the supine position

An accelerometer-based navigation system provides acetabular cup orientation accuracy comparable to that of computed tomography-based navigation during total hip arthroplasty in the supine position

In vivo kinematic analysis of patients with robotic‐assisted total hip arthroplasty during gait at 1‐year follow‐up

Mixed Reality Combined with Three‐Dimensional Printing Technology in Total Hip Arthroplasty: An Updated Review with a Preliminary Case Presentation

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