Comparison of Conventional Versus Computer-Navigated Acetabular Component Insertion

Haaker, Rolf; Tiedjen, K. U.; Ottersbach, Andreas; Rubenthaler, F.; Stockheim, M.; Stiehl, James B.

doi:10.1016/j.arth.2005.10.018

Cited by 99 publications

(50 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Precision in the computer-navigated anteversion values was approximately three times better than precision seen in the estimate of cup anteversion made by an experienced surgeon in that study. Similarly, Nogler et al [26] and Haaker et al [9] studied conventional cup placement with navigated cup placement via postoperative CT scanning. With surgeons in both studies attempting to place the acetabular component with 45°abduction and 20°anteversion, these studies also showed cups placed with computer navigation were more accurately placed, had lower standard deviations, and had fewer outliers.…”

Section: Discussionmentioning

confidence: 99%

CT Outperforms Radiography for Determination of Acetabular Cup Version after THA

Ghelman

Kepler

Lyman

et al. 2009

Clinical Orthopaedics &Amp; Related Research

103

102

View full text Add to dashboard Cite

Precise evaluation of acetabular cup version is necessary for patients with recurrent hip dislocation after THA. We retrospectively studied 42 patients, who underwent THAs, with multiple cross-table lateral radiographs and CT scans to determine whether radiographic or CT measurement of acetabular component version is more accurate. One observer measured cup version on all radiographs. CT scans were interpreted by one observer. Twenty radiographs were measured twice each by two observers to determine intraobserver and interobserver reliability. We implanted cups in four model pelvises using navigation and compared measurements of anteversion made with radiographs and CT scans. Intraclass correlation coefficients (ICC) for anteversion measurements of two observers were 0.9990 and 0.9998, respectively, when comparing measurements of identical radiographs (intraobserver). Paired values for two observers measuring the same radiograph had an ICC of 0.9686 (interobserver) compared with 0.7412 for measurements from serial radiographs of the same component. The ICC comparing radiographic versus CT-based measurements was 0.6981. CT measurements had stronger correlations with navigated values than radiographic measurements. Accuracy of anteversion measurements on crosstable radiographs depends on radiographic technique and patient positioning whereas properly performed CT measurements are independent of patient position.

show abstract

Section: Discussionmentioning

confidence: 99%

CT Outperforms Radiography for Determination of Acetabular Cup Version after THA

Ghelman

Kepler

Lyman

et al. 2009

Clinical Orthopaedics &Amp; Related Research

103

102

View full text Add to dashboard Cite

show abstract

“…On the other hand, Bosker et al [18] showed that the 70.5 % of cups in primary THA were positioned within the safe zone by a freehand technique. In recent studies, improved cup position using computer navigation [21,22] and its accuracy [23] have been reported.…”

Section: Discussionmentioning

confidence: 99%

Acetabular cup positioning in revision total hip arthroplasty with Paprosky type III acetabular defects: Martell radiographic analysis

Choi

Anderson

Foster

et al. 2013

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

Purpose This study evaluates acetabular cup position in the setting of revision total hip arthroplasty (THA) with severe acetabular bone defects. Methods With a definition of safe zone of abduction (30-50°) and anteversion (5-25°), acetabular cup position was measured by a digital image analysis program for 34 patients with Paprosky type III acetabular bone defects. Results There were 24 cups (71 %) for abduction and 26 cups (76 %) for anteversion located in the safe zone. Nineteen cups (56 %) were within the safe zone for both abduction and anteversion. There was no dislocation, however one cup out of the safe zone resulted in early cup failure due to aseptic loosening. Conclusions The acetabular cup positioning in patients with Paprosky type III defects was 'optimal' in half of the cases. The prevalence of optimal acetabular cup position was similar to those reported in primary THA, suggesting that the presence of a large acetabular bone defect may not be a significant risk factor for suboptimal acetabular cup positioning in the setting of revision THA.

show abstract

“…The 3D reconstruction was performed using the image reconstruction filter B before measurement. During measurement, the CT images were positioned such that the two reference planes were perpendicular to the plane of the monitor [10,15,25,27] (Fig. 3).…”

Section: Methodsmentioning

confidence: 99%

“…The literature documents variable positioning of acetabular cup placement in THA [1,5,10,41]. Extremes of component malpositioning are associated with an increased risk of dislocation and loosening [8,11,16,18,20,42,46].…”

Section: Introductionmentioning

confidence: 99%

Six Sigma Analysis of Minimally Invasive Acetabular Arthroplasty: A Preliminary Investigation

Heck¹,

Stiehl

2009

Clinical Orthopaedics &Amp; Related Research

Self Cite

View full text Add to dashboard Cite

Minimally invasive techniques in THA may increase the difficulty of acetabular component insertion relative to the optimized position. We sought to determine the ability of eight surgeons to position an acetabular component placed using an anterior-lateral minimally invasive surgical (MIS) approach with conventional instruments or computer navigation using an optical imageless protocol compared with conventional true values determined by computed tomography (CT). We introduce a new approach, the Six Sigma process capability index, to assess outliers. Using the Six Sigma process capability index (Cp [ 1.3) and the criteria of Lewinnek et al. of ± 10°for adequate precision, three-dimensional (3D) CT was capable for inclination and anteversion. Computer navigation and visual cues with conventional instrumentation were precise for anteversion but not for inclination. We conclude image-free computer navigation was not better than conventional instrumentation with the surgeons' visual cues for acetabular cup placement. Six Sigma analysis allows comparison of various methods of referencing with literature controls, and our data suggest CT referencing is the most precise method.

show abstract

Comparison of Conventional Versus Computer-Navigated Acetabular Component Insertion

Cited by 99 publications

References 32 publications

CT Outperforms Radiography for Determination of Acetabular Cup Version after THA

CT Outperforms Radiography for Determination of Acetabular Cup Version after THA

Acetabular cup positioning in revision total hip arthroplasty with Paprosky type III acetabular defects: Martell radiographic analysis

Six Sigma Analysis of Minimally Invasive Acetabular Arthroplasty: A Preliminary Investigation

Contact Info

Product

Resources

About