Smart mechanical navigation: Assuring cup positioning

Murphy, Stephen; Thomas, Anil O.

doi:10.1053/j.sart.2014.04.016

Cited by 1 publication

(1 citation statement)

References 29 publications

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“…The surgeon cannot use this tool in a vacuum and must still understand the pelvic position intra-operatively to accurately place the cup in the desired position. We acknowledge that this tool is a simple guide to help “find the target” but that it needs to be combined with methods to “hit the target” whether via anatomic references [29, 40], computer-aided navigation [41], robotic-guided instrumentation [42], or specialized jigs [43]. Currently this method focuses on FA as it relates to posterior instability or impingement, primarily associated with the posterior approach.…”

Section: Discussionmentioning

confidence: 99%

A Geometric Model to Determine Patient-Specific Cup Anteversion Based on Pelvic Motion in Total Hip Arthroplasty

Sutter

Wellman

Bolognesi

et al. 2019

Advances in Orthopedics

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Introduction. Cup position is critical to stability in total hip arthroplasty and is affected by pelvis motion during positions of daily life. The purpose of this study was to explicitly define the relationship between sagittal pelvic motion and resultant cup functional anteversion and create a tool to guide the surgeon to a patient-specific intra-operative anteversion. Materials and Methods. 10,560 combinations of inclination, anteversion, and pelvic tilt were generated using a geometric model. Resultant functional anteversion was calculated for each iteration and variables were correlated. An electronic mobile tool was created that compares inputted patient-specific values to population-based averages to determine pelvic positions and dynamics that may lead to instability. Results. A third-degree polynomial equation was used to describe the relationship between variables. The freely downloadable mobile tool uses input from pre-operative plain radiographic measurements to provide the surgeon a quantitative correction to intra-operative cup anteversion based on differences in functional anteversion compared to population-based averages. Conclusion. This study provides a geometric relationship between planned cup position, pelvic position and motion, and the resultant functional anteversion. This mathematical model was applied to an electronic tool that seeks to determine an individualized intra-operative cup anteversion based on measured patient-specific pelvic dynamics.

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