Improving registration accuracy during total hip arthroplasty: a cadaver study of a new, 3-D mini-optical navigation system

Cross, Michael B.; Schwarzkopf, Ran; Miller, Theodore T.; Bogner, Eric; Muir, Jeffrey M.; Vigdorchik, Jonathan M.

doi:10.5301/hipint.5000533

Cited by 19 publications

(12 citation statements)

References 44 publications

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“…Furthermore, in the supine DAA group 1 cup had to be excluded from the final analysis, reducing the number of cups analyzed. Nonetheless, these numbers are comparable to previously published cadaveric studies [5,37]. Also, the TTM of patient registration is a novel method that may require a learning phase before a surgeon becomes proficient in the technique.…”

Section: Discussionsupporting

confidence: 87%

“…Sendtner et al [31] showed similar accuracy and precision in their study with a mean error of 0.37° (SD 3.26°) for inclination and −5.61° (SD 6.48°) for anteversion. In a cadaveric study using an accelerometer-based navigation system, Cross et al [5] compared navigation to CT imaging and found a mean absolute error of 4.2° and 4.0° for inclination and version, respectively. In our current study, the mean absolute error was 2.3° and 4.1° for inclination and version, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Davis et al [6] used L5 spinous process and ASIS as landmarks. More recently, Cross et al [5] described a technique in the lateral position that did not require registration of bony landmarks; instead, position was registered by assuming the patient’s position and having the surgeon define the patient’s planes by fixing the tracker to an alignment rod. Disadvantages of early navigation systems include the bulkiness, radiation exposure [27,33,37,40], size, and cost of the robotic units.…”

Section: Introductionmentioning

confidence: 99%

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Improving Acetabular Component Positioning in Total Hip Arthroplasty: A Cadaveric Study of an Inertial Navigation Tool and a Novel Registration Method

2021

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Background: Incorrect acetabular component positioning in total hip arthroplasty (THA) has been associated with poor outcomes. Computer-assisted hip arthroplasty increases accuracy and consistency of cup positioning compared to conventional methods. Traditional navigation units have been associated with problems such as bulkiness of equipment and reproducibility of anatomical landmarks, particularly in obese patients or the lateral position. Purpose: We sought to evaluate the accuracy of a novel miniature inertial measurement system, the Navbit Sprint navigation device (Navbit, Sydney, Australia), to navigate acetabular component positioning in both the supine and lateral decubitus positions. We also aimed to validate a new method of patient registration that does not require acquisition of anatomical landmarks for navigation. Methods: We performed THA in a cadaveric study in supine and lateral positions using Navbit navigation to record cup position and compared mean scores from 3 Navbit devices for each cup position on post-implantation CT scans. Results: A total of 11 cups (5 supine and 6 lateral) were available for comparison. A difference of 2.34° in the supine direct anterior approach when assessing acetabular version was deemed to be statistically but not clinically significant. There was no statistically significant difference between CT and navigation measurements of cup position in the lateral position. Conclusion: This cadaveric study suggests that a novel inertial-based navigation tool is accurate for cup positioning in THA in the supine and lateral positions. Furthermore, it validates a novel registration method that does not require the identification of anatomical landmarks.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Improving Acetabular Component Positioning in Total Hip Arthroplasty: A Cadaveric Study of an Inertial Navigation Tool and a Novel Registration Method

2021

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“…The CT scans of six cadavers (one female, five male) used in previous THA studies [21][22][23] and 14 patients (nine female, five male) undergoing primary THA were obtained using a GE LightSpeed™ 16 imager (GE Healthcare, Chicago, Illinois; 140 kV, 600 mA at 0.8 sec revolution time and 0.625 mm slice thickness). Each CT scan was segmented using medical image computing software (3-D Slicer, version 4.6 [24]).…”

Section: Ct Scansmentioning

confidence: 99%

A Novel Method for Correcting Pelvic Tilt on Anteroposterior Pelvic Radiographs

Muir¹,

Vincent²,

Schipper³

et al. 2019

Cureus

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“…However, this observation corresponds with a report by Chechik et al [28] that indicates the direct anterior approach is less used in the United States, and the authors could not control for this retrospectively. Intraoperative device HCOR measurements are relative to the patient positioning captured at the time of registration; therefore, any deviations from the true patient position at registration may be reflected when capturing HCOR [29,30]. This is of particular importance with respect to the small yet significant difference in A-P HCOR displacement observed between anterior and lateral/posterior cases.…”

Section: Discussionmentioning

confidence: 99%

Surgical Approach and Reaming Depth Influence the Direction and Magnitude of Acetabular Center of Rotation Changes During Total Hip Arthroplasty

et al. 2020

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Background: Changes in acetabular or hip center of rotation (HCOR) commonly occur during acetabular component preparation during total hip arthroplasty (THA). HCOR displacement in mediolateral or superoinferior directions is known to influence offset and leg length, but the incidence and range of HCOR change in the anteroposterior direction is less understood as the sagittal plane cannot be measured on standard anteroposterior radiographs. This study assessed the 3-dimensional displacement of HCOR after cup implantation and evaluated for potential factors associated with increased acetabular component translations. Methods: A total of 894 THAs were performed using a posterior, lateral, or direct anterior approach. Only intraoperative data from the navigation device were included in the analysis. All THAs performed between September 2015 and October 2017 were included. Paired t-tests were used to compare native HCOR and new HCOR values. Results: The mean HCOR displacement in 3 directions was 4.97mm medially (P < .001), 0.83mm superiorly (P < .001), and 0.64mm posteriorly (P < .001). Subgroup analysis revealed greater posterior HCOR displacement with the anterior approach than the lateral/posterior approach (2.32mm vs 0.44mm; P < .001). Increasing medial HCOR displacement also resulted in increased superior and posterior HCOR displacement across surgical cases (P < .001). Conclusions: HCOR displacement is commonly observed in medial, superior, and posterior directions. HCOR changes are influenced by surgical approach, potentially secondary to patient positioning, with greater posterior HCOR displacement observed in anterior cases. Surgeons should be aware of these factors, particularly in cases with deficient or reduced posterior column bone stock.

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Improving registration accuracy during total hip arthroplasty: a cadaver study of a new, 3-D mini-optical navigation system

Abstract: This study demonstrates that the registration error associated with this new mini-navigation system compares favourably with the known registration error associated with traditional navigation systems.

Cited by 19 publications

References 44 publications

Improving Acetabular Component Positioning in Total Hip Arthroplasty: A Cadaveric Study of an Inertial Navigation Tool and a Novel Registration Method

Improving Acetabular Component Positioning in Total Hip Arthroplasty: A Cadaveric Study of an Inertial Navigation Tool and a Novel Registration Method

A Novel Method for Correcting Pelvic Tilt on Anteroposterior Pelvic Radiographs

Surgical Approach and Reaming Depth Influence the Direction and Magnitude of Acetabular Center of Rotation Changes During Total Hip Arthroplasty

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