Improving the Accuracy of Acetabular Component Orientation: Avoiding Malposition

Moskal, Joseph T.; Capps, Susan G.

doi:10.5435/00124635-201005000-00005

Cited by 57 publications

(50 citation statements)

References 44 publications

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“…Transverse acetabular ligament has been suggested as one of the soft tissue landmarks by Archbold et al [20] along with the acetabular rim and labrum. The main advantage of these structures being the 3-dimensional view and the patient specific morphology [19]. But the limitation we faced was the problem of defining the structures especially in very obese patients or in acetabuli affected by trauma or dysplasia.…”

Section: Discussionmentioning

confidence: 99%

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Validation of navigation assisted cup placement in total hip arthroplasty

Kumar¹,

Shetty²,

Kiran³

et al. 2011

International Orthopaedics (SICOT)

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Purpose Computer navigation has the potential to provide precise intraoperative knowledge to the surgeon. Previous studies with navigation have confirmed its function for improved component position but few studies have reported the accuracy and precision of navigation system in clinical use. With this study we propose to evaluate the efficacy of navigation in guiding cup placement. Methods Fifty-six patients undergoing primary total hip arthroplasty were prospectively included in this study. Stryker imageless navigation system which is accurate to 0.5°was used in all cases. Intraoperative data was collected for the acetabular component position using navigation for the freehand cup placement and the final cup placement done using navigation. Postoperative evaluation of component position was done with computed tomography (CT) and the deviation from intraoperative freehand and navigation values were calculated. Results The mean inclination of the freehand reading was 39.5°(range, 20°-58°), mean version of freehand reading was 10.7°(−6°-27°), and the mean navigation reading was 43.2°(37°-49°) for inclination and 13.0°(−8°-24°) for version. On postoperative CT scan analysis the mean inclination was 45.3°(34°-56°) and mean version was 15.1°(4°-25°). The deviation of the freehand inclination from the post operative CT scan reading was 11.4°(1°-30°) and the version deviated by a mean of 10.8°(2°-26°). The deviation of the navigation reading from the CT scan reading had a mean of 5.3°(1°-13°) for inclination and 5.6°( 1°-17°) for version. Conclusion The accuracy of the navigation system over conventional freehand cup placement is validated by this study.

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Section: Discussionmentioning

confidence: 99%

“…Lewinnek et al [13] have defined a safe zone for the acetabular component placement which they postulated would bring down the incidence of these complications. The safe zone widely accepted by various authors is inclination of 40°±10°and anteversion of 15°±10° [14,18,19].…”

Section: Discussionmentioning

confidence: 99%

Validation of navigation assisted cup placement in total hip arthroplasty

Kumar¹,

Shetty²,

Kiran³

et al. 2011

International Orthopaedics (SICOT)

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“…However, there have been no reports describing the usefulness of such navigation systems to inexperienced surgeons. These systems may assist inexperienced surgeons in correct placement of the acetabular cup [12], but may also result in more complicated operations and may not lead to good results.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of angle and position of the cup using computed tomography-based navigation systems in total hip arthroplasty

Iwana

Nakamura

Miki

et al. 2013

Computer Aided Surgery

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Objective: The objectives of this study were to evaluate the accuracy of computed tomography (CT)-based navigation and to investigate whether the level of surgeon experience affects the accuracy of cup positioning under navigation. Methods: This study investigated 117 hips in 103 patients who underwent primary total hip arthroplasty (THA) by 7 surgeons using a CT-based navigation system. Pre-and postoperative CT images were matched using a volume registration technique. Postoperative cup angles and positions were then measured using the same pelvic coordinates, and results were compared for experienced and inexperienced surgeons. Results: The mean absolute error of the cup angle was 1.8 AE 1.6 for inclination and 1.2 AE 1.1 for anteversion. The mean absolute errors of cup position were 1.9 AE 1.5 mm, 1.4 AE 1.2 mm, and 1.9 AE 1.3 mm on the x-, y-and z-axes, respectively. No significant differences in accuracy were identified between experienced and inexperienced surgeons. Conclusions:The absolute spatial error of cup position was 2 mm for each axis, and the angle error was 2 for the angles of inclination and anteversion. This navigation system could therefore help surgeons perform accurate cup placement irrespective of the surgeon's level of experience.

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“…Malposition of the acetabular cup can cause impingement, eccentric polyethylene wear and osteolysis, migration of acetabular component and dislocation of the joint, resulting in early failure of THA [1,2].…”

Section: Introductionmentioning

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)

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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.

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Improving the Accuracy of Acetabular Component Orientation: Avoiding Malposition

Cited by 57 publications

References 44 publications

Validation of navigation assisted cup placement in total hip arthroplasty

Validation of navigation assisted cup placement in total hip arthroplasty

Accuracy of angle and position of the cup using computed tomography-based navigation systems in total hip arthroplasty

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

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