Accuracy of Navigation-Assisted Acetabular Component Positioning Studied by Computed Tomography Measurements

Ybinger, Thomas; Kumpan, W; Hoffart, H E; Muschalik, B; Bullmann, W; Zweymüller, K.

doi:10.1016/j.arth.2006.10.001

Cited by 81 publications

(88 citation statements)

References 15 publications

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“…In this context, combined femoral and acetabular component navigation represents an appealing concept to further optimise implant orientation potentially improving the clinical outcome in HR. However, there is a need to overcome limitations associated with acetabular component navigation with regard to accuracy and practicability of landmark registration [45].…”

Section: Systematic Review Resultsmentioning

confidence: 99%

The First SICOT Oral Presentation Award 2011: Imageless computer-assisted femoral component positioning in hip resurfacing: a prospective randomised trial

Stiehler

Goronzy

Hartmann

et al. 2013

International Orthopaedics (SICOT)

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Purpose The aim of the study was to evaluate the effects of imageless computer-assisted surgery (CAS) on the accuracy of positioning of the femoral component and on the shortterm clinical outcome in hip resurfacing (HR) using a randomised prospective design. Methods A total of 75 consecutive patients undergoing HR were randomly allocated to CAS and conventional implantation, respectively. Preoperatively and six months postoperatively standardised pelvic anteroposterior X-ray images, the total Western Ontario and McMaster Universities Osteoarthritis Index, the Harris Hip Score and the EQ-5D utility index were evaluated in a blinded manner. The primary end point of the study was a post-operative femoral component malpositioning in five degrees or more either varus or valgus absolute deviation from the planned stem shaft angle. Results Patient demographics and algofunctional scores did not differ between the CAS and conventional implantation samples. Using CAS fewer femoral components were positioned in five or more degrees absolute deviation (4/37 vs 12/38, Fisher's exact p=0.047; 95 % confidence interval for the primary end point's incidence difference: +3 %; +39 %); the respective incidences of five or more degrees of varus deviation were 0/37 vs 5/38. One conversion to a stemmed prosthesis (CAS group) was performed for periprosthetic femoral neck fracture. Radiological signs of superolateral femoral neck/implant impingement were observed in two cases (one CAS-based and one conventional implantation). Conclusions The accuracy of femoral HR component positioning was significantly improved using CAS. However, one major complication necessitated early revision in the CAS group at six months of observation. Apart from that adverse event no inter-group differences were observed for the short-term clinical outcome. Future studies need to address the clinical long-term relevance of CAS in HR.

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Section: Systematic Review Resultsmentioning

confidence: 99%

The First SICOT Oral Presentation Award 2011: Imageless computer-assisted femoral component positioning in hip resurfacing: a prospective randomised trial

Stiehler

Goronzy

Hartmann

et al. 2013

International Orthopaedics (SICOT)

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“…The authors have recently provided data from a prospective study of 37 patients (20 females, 17 males, mean age 65 years, and 18 right and 19 left hip joints) undergoing THAs with the PiGalileo THR system at four contributing centers [16]. All patients received a cementless threaded biconical cup of pure titanium with a polyethylene inlay and a cementless tapered straight titanium alloy stem with a ceramic ball head (Plus Orthopedics, Rotkreuz, Switzerland).…”

Section: Ct-free Navigationmentioning

confidence: 99%

Enhanced acetabular component positioning through computer-assisted navigation

Ybinger

Kumpan

2007

International Orthopaedics (SICO

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Optimal positioning of the acetabular component improves the long-term success of total hip arthroplasty by reducing the rate of adverse outcomes, such as component wear and dislocation. Mechanical guides designed to facilitate proper component orientation are inadequate, as they do not account for variations in patient position and pelvic motion during surgery. Pioneering image-guided surgical navigation systems were developed to provide surgeons with improved methods for intraoperatively measuring orientation and alignment. Although enhanced orientation has been reported with such systems, they require preoperative CT scans and are therefore limited by the need for preplanning, the necessitiy of matching CT data with the actual patient position, and the additional costs associated with CT. The recent development of CTfree navigational tools addresses these disadvantages and offers real-time surgical feedback regarding the actual position of the acetabular component and instruments relative to the pelvis. Proper training and enhanced identification of bony landmarks will improve upon the success of these systems.

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“…Superior femoral neck notching may be caused by inferior or valgus malpositioning of the femoral component and has been implicated in mechanical weakening [18,20] of the femoral neck and impairment of vascularity of the femoral head [3]. Studies on the use of computer navigation in THA have shown an improvement in acetabular component alignment in patients when compared with a conventional jig-based technique [10,11,13,14,26,27]. These studies all examined placement of the acetabular cup using navigation and concluded navigation in THA improves accuracy of cup placement by decreasing the number of outliers from the desired alignment.…”

Section: Introductionmentioning

confidence: 99%

Component Alignment in Hip Resurfacing Using Computer Navigation

Bailey

Gul

Falworth

et al. 2008

Clin Orthop Relat Res

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The use of computer navigation during hip resurfacing has been proposed to reduce the risk of a malaligned component and notching with subsequent postoperative femoral neck fracture. Femoral component malalignment and notching have been identified as the major factors associated with femoral neck fracture after hip resurfacing. We performed 37 hip resurfacing procedures using an imageless computer navigation system. Preoperatively, we generated a patient-specific computer model of the proximal femur and planned a target angle for placement of the femoral component in the coronal plane. The mean navigation angle after implantation (135.5°) correlated with the target stem-shaft angle (135.4°). After implantation, the mean stem-shaft angle of the femoral component measured by three-dimensional computed tomography (135.1°) correlated with the navigation target stem-shaft angle (135.4°). The computer navigation system generates a reliable model of the proximal femur. It allows accurate placement of the femoral component and provides precise measurement of implant alignment during hip resurfacing, thereby reducing the risk of component malpositioning and femoral neck notching.

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Accuracy of Navigation-Assisted Acetabular Component Positioning Studied by Computed Tomography Measurements

Cited by 81 publications

References 15 publications

The First SICOT Oral Presentation Award 2011: Imageless computer-assisted femoral component positioning in hip resurfacing: a prospective randomised trial

The First SICOT Oral Presentation Award 2011: Imageless computer-assisted femoral component positioning in hip resurfacing: a prospective randomised trial

Enhanced acetabular component positioning through computer-assisted navigation

Component Alignment in Hip Resurfacing Using Computer Navigation

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