Comparison of a mechanical acetabular alignment guide with computer placement of the socket

DiGioia, Anthony M.; Jaramaz, Branislav; Plakseychuk, Anton; Moody, James E.; Nikou, Constantinos; LaBarca, Richard S.; Levison, Timothy J.; Picard, F.

doi:10.1054/arth.2002.30411

Cited by 310 publications

(177 citation statements)

References 17 publications

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“…There have been numerous reports regarding the optimal orientation of the acetabular component in THA [1][2][3][4][5]8]. Although debate remains on this topic, the classical target for cup orientation in THA is the so-called ''Lewinnek safe zone'' with an abduction angle of 40°± 10°and an anteversion angle of 15°± 10° [1][2][3][4][5]8]. Use of mechanical acetabular guides for intraoperative alignment leads to variations between the actual and desired implant orientation mainly as a result of the variations of the patient position on the operative table [5].…”

Section: Introductionmentioning

confidence: 99%

“…Although debate remains on this topic, the classical target for cup orientation in THA is the so-called ''Lewinnek safe zone'' with an abduction angle of 40°± 10°and an anteversion angle of 15°± 10° [1][2][3][4][5]8]. Use of mechanical acetabular guides for intraoperative alignment leads to variations between the actual and desired implant orientation mainly as a result of the variations of the patient position on the operative table [5]. To limit the potential cup malposition, computer-assisted orthopaedic navigation systems were developed in the early 2000s.…”

Section: Introductionmentioning

confidence: 99%

“…To limit the potential cup malposition, computer-assisted orthopaedic navigation systems were developed in the early 2000s. After initial adoption and demonstration of their usefulness to improve the reliability of cup placement [5,6,18], standard computer-assisted systems have been improved to limit the extra time required for the procedure. The latest evolution of computer-assisted surgery (CAS) for THA has been recently introduced based on systems using robotic-assisted computer navigation.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

No Benefit After THA Performed With Computer-assisted Cup Placement: 10-year Results of a Randomized Controlled Study

Parratte

Ollivier

Lunebourg

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Computer-assisted surgery (CAS) for cup placement has been developed to improve the functional results and to reduce the dislocation rate and wear after total hip arthroplasty (THA). Previously published studies demonstrated radiographic benefits of CAS in terms of implant position, but whether these improvements result in clinically important differences that patients might perceive remains largely unknown.Questions/purposes We hypothesized that THA performed with CAS would improve 10-year patient-reported outcomes measured by validated scoring tools, reduce acetabular polyethylene wear as measured using a validated radiological method, and increase survivorship. Methods Sixty patients operated on for a THA between April 2004 and April 2005 were randomized into two groups using either the CAS technique or a conventional technique for cup placement. All patient candidates for a THA with the diagnosis of primary arthritis or avascular necrosis were eligible for the CAS procedure and randomly assigned to the CAS group by the Hospital Informatics Department with use of a systematic sampling method. The patients assigned to the freehand cup placement group were matched for sex, age within 5 years, pathological condition, operatively treated side, and body mass index within 3 points. All patients were operated on through an anterolateral approach (patient in the supine position) using cementless implants. In the CAS group, a specific surgical procedure using an imageless cup positioning computerbased navigation system was performed. There were 16 men and 14 women in each group; mean age was 62 years (range, 24-80 years), and mean body mass index was 25 ± 3 kg/m 2 . No patient was lost to followup at 10 years, but five patients have died (two in the CAS group and three in the control group). At the 10-year followup, an independent observer blinded to the type of technique performed patients' evaluation. Cup positioning was evaluated postoperatively using a CT scan in the two groups with results previously published. At 10 years, we assessed subjective functional outcome and quality of life using validated questionnaires (SF-12, Harris hip score [HHS], Hip injury and Osteoarthritis Outcome Score). Wear rate was then evaluated on standardized radiographs using a previously validated semiautomated computer analogic measurement Each author certifies that he, or a member of his immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Clinical Orthopaedics and Related Research 1 neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDAapproval status, of any dr...

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

No Benefit After THA Performed With Computer-assisted Cup Placement: 10-year Results of a Randomized Controlled Study

Parratte

Ollivier

Lunebourg

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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“…Diese "safe zone" der Pfannenposition wird jedoch bei der konventionellen Operationstechnik auch von erfahrenen Operateuren in bis zu 78% der Hüftendoprothe-senimplantationen nicht erreicht [1,5,8] Die Pfannenposition ist entscheidend für die Funktion einer Hüftge-lenktotalendoprothese. Allerdings kann bei konventionellen Operationsverfahren eine korrekte Pfannenposition aufgrund der fehlenden Information über die Beckenstellung häufig nicht erreicht werden.…”

Section: Introductionunclassified

“…Eine ungenaue Pfannenimplantation außerhalb dieser "safe zone" schränkt den möglichen Bewegungsumfang (range of motion) des künstlichen Hüft-gelenkes ein, kann durch unphysiologische Belastungen zu einem erhöhten Abrieb der Gleitflächen und zu einer vorzeitigen aseptischen Prothesenlockerung führen sowie eine erhöhte Luxationsgefahr bedingen [2,11,18].Diese "safe zone" der Pfannenposition wird jedoch bei der konventionellen Operationstechnik auch von erfahrenen Operateuren in bis zu 78% der Hüftendoprothe-senimplantationen nicht erreicht [1,5,8] Die Pfannenposition ist entscheidend für die Funktion einer Hüftge-lenktotalendoprothese. Allerdings kann bei konventionellen Operationsverfahren eine korrekte Pfannenposition aufgrund der fehlenden Information über die Beckenstellung häufig nicht erreicht werden.…”

unclassified

Genauigkeit eines bildfreien Navigationssystemes für die Hüftpfannenimplantation – eine anatomische Studie / Accuracy of an Image-free Cup Navigation System – an Anatomical Study

Kalteis¹,

Beckmann²,

Herold³

et al. 2004

Biomedizinische Technik/Biomedical Engineering

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EinleitungLewinnek hat in klinischen und anatomischen Studien die Komplikationsraten der Hüftgelenkendoprothetik mit der Pfannenausrichtung korreliert und die sogenannte "safe zone" der Pfannenimplantation mit einer Inklinationsstellung von 45 ± 10°und einer Anteversion von 15 ± 10°definiert [13]. Eine ungenaue Pfannenimplantation außerhalb dieser "safe zone" schränkt den möglichen Bewegungsumfang (range of motion) des künstlichen Hüft-gelenkes ein, kann durch unphysiologische Belastungen zu einem erhöhten Abrieb der Gleitflächen und zu einer vorzeitigen aseptischen Prothesenlockerung führen sowie eine erhöhte Luxationsgefahr bedingen [2,11,18].Diese "safe zone" der Pfannenposition wird jedoch bei der konventionellen Operationstechnik auch von erfahrenen Operateuren in bis zu 78% der Hüftendoprothe-senimplantationen nicht erreicht [1,5,8] Die Pfannenposition ist entscheidend für die Funktion einer Hüftge-lenktotalendoprothese. Allerdings kann bei konventionellen Operationsverfahren eine korrekte Pfannenposition aufgrund der fehlenden Information über die Beckenstellung häufig nicht erreicht werden. Für CT-basierte und Fluoroskopie-gestützte Navigationsverfahren konnte eine signifikante Verbesserung der Implantationsgenauigkeit nachgewiesen werden. Die Akzeptanz dieser Systeme ist jedoch aufgrund der zusätzlichen Strahlenbelastung, der hohen Kosten sowie des vermehrten Zeitaufwandes gering. In der vorliegenden anatomischen Studie wurde ein alternatives Navigationsverfahren, die bildfreie Navigation, hinsichtlich ihrer Genauigkeit untersucht. Das bildfreie Navigationssystem ist mit wenigen zusätzlichen Arbeitsschritten verbunden, führt zu keiner wesentlichen Verzögerung der Operation und benötigt keine zusätzliche Bildgebung. An 10 Hüften humaner Leichen wurden Press-fit-Pfannen bildfrei navigiert implantiert und die Pfannenposition intraoperativ mit einem CTbasierten Navigationssystem sowie postoperativ im Becken-CT kontrolliert. Mit einer durchschnittlichen Inklination von 44°(Spanne 40-48°, SABW 2,7°) und einer Anteversion von 18°(Spanne 12-24°, SABW 4,1°) lagen alle Pfannen im Bereich der angestrebten safe zone. Die Genauigkeitsanalyse der bildfreien Navigationssoftware ergab im Vergleich zum CT-basierten Navigationssystem sowie zur postoperativen Becken-CT eine nur geringe, für den klinischen Einsatz tolerable Abweichung für die Pfanneninklination und -anteversion. Das getestete bildfreie Navigationssystem erscheint als eine in der klinischen Routine praktikable und zuverlässige Alternative für die computerunterstützte Implantation von Hüftgelenkspfannen.Key words: Computer-assisted surgery -Image-free navigation -Hip arthroplasty -Hip endoprosthesisThe position of the acetabular cup is of decisive importance for the function of a total hip replacement (THR). Using the conventional surgical technique, correct placement of the cup often fails due to a lack of information about pelvic tilt. With CT-based and fluoroscopicallyassisted navigation procedures the accuracy of implantation has been significantly impro...

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Computer Navigation in Total Hip Arthroplasty

Malik

Dorr

2021

Evidence‐Based Orthopedics

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Comparison of a mechanical acetabular alignment guide with computer placement of the socket

Cited by 310 publications

References 17 publications

No Benefit After THA Performed With Computer-assisted Cup Placement: 10-year Results of a Randomized Controlled Study

No Benefit After THA Performed With Computer-assisted Cup Placement: 10-year Results of a Randomized Controlled Study

Genauigkeit eines bildfreien Navigationssystemes für die Hüftpfannenimplantation – eine anatomische Studie / Accuracy of an Image-free Cup Navigation System – an Anatomical Study

Computer Navigation in Total Hip Arthroplasty

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