Total Hip Arthroplasty Using Imageless Computer-Assisted Hip Navigation

Lass, Richard; Kubista, Bernd; Olischar, Boris; Frantal, Sophie; Windhager, Reinhard; Giurea, Alexander

doi:10.1016/j.arth.2013.08.020

Cited by 125 publications

(122 citation statements)

References 36 publications

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“…91% of cups were within 10° of both the planned inclination and anteversion [24]. These results are comparable with published data on the precision of computer-assisted THA surgery [16][17][18][19], summarised in Table 1. Importantly, the OPS™ system defines a patient-specific target derived from functional, dynamic analysis, and does not require any registration to define the intraoperative reference frame.…”

Section: Discussionsupporting

confidence: 82%

See 1 more Smart Citation

Patient Specific Component Alignment in Total Hip Arthroplasty

Pierrepont

Stambouzou²,

Miles³

et al. 2016

ReconRev

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Appropriate component alignment is critical for improving stability, maximising bearing performance and restoring native anatomy after Total Hip Arthroplasty (THA). Due to the large variation in patient kinematics between functional activities, current technologies lack definition of what constitutes correct target alignment. Analysis of a large series of symptomatic THA patients confirms that apparently wellorientated components on standard radiographs can still fail due to functional component malalignment. Evidently, previously defined "safe zones" are not appropriate for all patients as they do not consider the dynamic behaviour of the hip joint.The Optimized Positioning System™ (OPS™) comprises preoperative planning based on a patientspecific dynamic analysis, and patient-specific instrumentation for delivery of the target component alignment. This paper presents the application of OPS™ in three case studies.

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Section: Discussionsupporting

confidence: 82%

“…Fortunately, the procedure is relatively forgiving of component malalignment, and this has concealed the poor levels of precision achievable without assistive technologies [2][3][4][16][17][18][19][20][21]. Despite the generally high rates of patient satisfaction, failures still occur.…”

Section: Discussionmentioning

confidence: 99%

Patient Specific Component Alignment in Total Hip Arthroplasty

Pierrepont

Stambouzou²,

Miles³

et al. 2016

ReconRev

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show abstract

“…Surgical navigation has been demonstrated to improve the accuracy and precision of component positioning compared to traditional freehand techniques [4]. Use of surgical navigation also offers the surgeon the ability to make fine modifications to component position based on patient factors such as pelvic tilt (PT)[5].…”

Section: Introductionmentioning

confidence: 99%

Pelvic Tilt in Patients Undergoing Total Hip Arthroplasty: When Does it Matter?

Maratt¹,

Esposito²,

McLawhorn³

et al. 2015

The Journal of Arthroplasty

179

152

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Pelvic tilt (PT) affects the functional anteversion and inclination of acetabular components in total hip arthroplasty (THA). One-hundred and thirty-eight consecutive patients who underwent unilateral primary THA were reviewed. Most cases had some degree of pre-operative PT, with 17% having greater than 10° of PT on standing pre-operative radiographs. There was no significant change in PT following THA. A computer model of a hemispheric acetabular component implanted in a range of anatomic positions in a pelvis with varying PT was created to determine the effects of PT on functional anteversion and inclination. Based on the study results, tilt-adjustment of the acetabular component position based on standing pre-operative imaging will likely improve functional component position in most patients undergoing THA.

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“…Importantly these findings were achieved with a device that is no more intrusive or disruptive to the surgical workflow than any of the manual methods traditionally utilized. Indeed, in our study, the average procedure time was 76 minutes, which compares favourably with procedures utilizing mechanical measurement techniques, which range in duration from 73 [23, 44] to 104 minutes [45]. Conversely, computer-assisted navigation is associated with significant increases in procedural time, reported between 12 [46, 47] and 23 added minutes [23, 44, 45, 48].…”

Section: Discussionmentioning

confidence: 61%

A Smart Tool for Intraoperative Leg Length Targeting in Total Hip Arthroplasty: A Retrospective Cohort Study

Grosso¹,

Snider²,

Muir³

2016

TOORTHJ

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Background:Leg length discrepancies following total hip arthroplasty (THA) may necessitate subsequent interventions, from heel lifts to revision surgery. Current intraoperative methods of determining leg length are either inaccurate or expensive and invasive.Objective:The objective of the current study was to investigate the ability of a novel, intraoperative smart tool (Intellijoint HIP®, Intellijoint Surgical®, Inc., Waterloo, ON) to provide accurate, real-time leg length measurements during THA.Methods:We retrospectively reviewed the medical records of 25 patients who underwent THA utilizing the Intellijoint HIP smart tool between February and August 2014. Intraoperative leg length data was compared with radiographic leg length calculations. Two observers blinded to the Intellijoint HIP findings independently assessed all post-procedure radiographs.Results:The mean difference between smart tool and radiographic measurements was 1.3 mm [CI: -0.1, 2.7]. 88% (22/25) of intraoperative measurements were within 5 mm of radiographic measurements; 100% (25/25) were within 10 mm. A Bland-Altman analysis showed excellent agreement, with 96% (24/25) of measurements within the statistical limit for acceptable agreement, and 84% (21/25) within the clinically acceptable range (± 5 mm). Removal of the first 13 procedures (surgeon training) decreased the mean difference between methods to 0.6 mm [-0.6, 1.9]. All post-training procedures were associated with a difference of <5 mm. There were no reported adverse events related to the use of the smart tool.Conclusion:The Intellijoint HIP smart tool is a safe and accurate tool for providing intraoperative measurements of leg length in real-time.

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Total Hip Arthroplasty Using Imageless Computer-Assisted Hip Navigation

Cited by 125 publications

References 36 publications

Patient Specific Component Alignment in Total Hip Arthroplasty

Patient Specific Component Alignment in Total Hip Arthroplasty

Pelvic Tilt in Patients Undergoing Total Hip Arthroplasty: When Does it Matter?

A Smart Tool for Intraoperative Leg Length Targeting in Total Hip Arthroplasty: A Retrospective Cohort Study

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