Imageless computer navigation without pre-operative templating may lead to malpreparation of the femoral head in hip resurfacing

Olsen, Michael; Davis, Edward T.; Chiu, Mark Chih-Hung; Gamble, Patrick; Tumia, Nezar; Boyle, R. A.; Schemitsch, Emil H.

doi:10.1302/0301-620x.91b10.22020

Cited by 2 publications

(1 citation statement)

References 29 publications

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“…The role of computer navigation also remains unresolved. [45][46][47] The preservation of femoral bone stock with hip resurfacing also brought concerns about preserving the blood supply to the femoral head. [48][49][50] The importance of the medial femoral circumflex artery was already well known, 48 and this was emphasised by clinical studies that assessed blood flow and surgical approach.…”

Section: The Presentmentioning

confidence: 99%

Resurfacing registers concern

Simpson

Villar

2010

The Journal of Bone and Joint Surgery. British volume

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We review the history and literature of hip resurfacing arthroplasty. Resurfacing and the science behind it continues to evolve. Recent results, particularly from the national arthroplasty registers, have spread disquiet among both surgeons and patients. A hip resurfacing arthroplasty is not a total hip replacement, but should perhaps be seen as a means of delaying it. The time when hip resurfacing is offered to a patient may be different from that for a total hip replacement. The same logic can apply to the timing of revision surgery. Consequently, the comparison of resurfacing with total hip replacement may be a false one. Nevertheless, the need for innovative solutions for young arthroplasty patients is clear. Total hip replacement can be usefully delayed in many of these patients by the use of hip resurfacing arthroplasty.

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Section: The Presentmentioning

confidence: 99%

Resurfacing registers concern

Simpson

Villar

2010

The Journal of Bone and Joint Surgery. British volume

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No added value for Computer-Assisted surgery to improve femoral component positioning and Patient Reported Outcomes in Hip Resurfacing Arthroplasty; a multi-center randomized controlled trial

Koper

Reijman

et al. 2019

BMC Musculoskelet Disord

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BackgroundComputer Assisted Surgery (CAS) has proven to improve the accuracy in several orthopedic procedures. Therefore we used this technique to evaluate femoral component positioning in Hip Resurfacing Arthroplasty (HRA). The aim of this study was to evaluate imageless CAS compared to manually implanted femoral components and subsequently evaluates Patient Related Outcome Measures (PROMs). We hypothesized that the use of CAS optimizes the position of the femoral component and improves PROMs.MethodsThis is a multicenter, single-blinded, randomized, controlled trial of two groups. In the CAS group guiding of the femoral component was done with imageless navigation. In the Conventional (control) group the femoral component was placed manually according to the preplanned position. The primary outcome measure consists of a maximum of 3 degrees difference between the postoperative Stem Shaft Angle (SSA) and preplanned SSA. Secondary outcome measures consist of the Hip disability and Osteoarthritis Outcome Scale (HOOS), the Harris Hip Score (HHS) and Visual Analogue Scale (VAS) pain score.ResultsA total of 122 patients were randomized, 61 in the CAS group and 61 in the conventional group. There was no significant differences in accuracy of femoral implant position. The mean difference between the postoperative- and preplanned SSA was − 2.26 and − 1.75 degrees (more varus) respectively in the CAS and Conventional group. After surgery both groups show significant improvement in all PROMs compared to the baseline measurements, with no significant differences between the groups.ConclusionOur cohort indicates no benefit for the use of CAS in accuracy of placement of the femoral component in HRA compared to manual implantation. There are no clinical differences in PROMs after 1 year follow up. This study showed no added value and no justification for the use of CAS in femoral component positioning in HRA.Trial registrationThis trial is registered at ClinicalTrails.gov (https://clinicaltrials.gov/) on the 25th of October 2006: NCT00391937.Level of incidenceLevel IIb, multicenter randomized controlled trial.

show abstract

Imageless computer navigation without pre-operative templating may lead to malpreparation of the femoral head in hip resurfacing

Cited by 2 publications

References 29 publications

Resurfacing registers concern

Resurfacing registers concern

No added value for Computer-Assisted surgery to improve femoral component positioning and Patient Reported Outcomes in Hip Resurfacing Arthroplasty; a multi-center randomized controlled trial

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