Validation of a Novel Software Measurement Tool for Total Hip Arthroplasty

Abstract

BackgroundPreoperative planning and postoperative evaluation of component position in total hip arthroplasty (THA) utilize specialized software that must be able to provide measurements that are both accurate and precise. A new software program for use in THA has recently been developed. We sought to evaluate the accuracy of this new software in comparison with two current, widely used software programs. MethodologyPostoperative anteroposterior (AP) pelvic radiographs from 135 THA patients were retrospectively reviewed. Reference values for acetabular anteversion, inclination, and leg length were established using validated software programs (TraumaCad ® as the primary reference value [PRV] and OsiriX Lite TM as the secondary reference value [SRV]). Measurements from the new software program (Intellijoint VIEW TM ) were compared with reference values using Student's t-test and chi-square test. ResultsFor anteversion, mean values for the PRV (27.34° ± 7.27°) and the new software (27.29° ± 7.21°) were not significantly different (p = 0.49). The new software differed from the PRV by a mean of 0.05° ± 0.93°. Similar results were noted for inclination, where the new software differed from the PRV and SRV by -0.13° ± 0.65°a nd 0.25° ± 1.26°, respectively (mean values: PRV: 43.62° ± 6.02°; SRV: 43.99° ± 6.27°; new software: 43.74° ± 6.17°; p = 0.87), and for leg length, where the new software differed from the PRV and SRV by 0.05 mm ± 0.46 mm and 0.22 mm ± 0.52 mm, respectively (mean values: PRV: 10.61 mm ± 11.60 mm; SRV: 10.77 mm ± 11.70 mm; new software: 10.56 mm ± 11.61 mm; p = 0.98). Measurements were highly correlated across multiple reviewers (intraclass correlation coefficient ≥0.987). ConclusionsThe new software measurement tool is accurate and precise for assessing the acetabular component position and leg length measurements following THA in AP pelvic radiographs compared to currently used image measurement software.

Fluoroscopy Versus Imageless Optical Navigation in Direct Anterior Approach Total Hip Arthroplasty

“…Each outcome was measured using a validated web-based tool for surgical planning and evaluating postoperative acetabular cup placement and LLD in THA (Intellijoint VIEW, Intellijoint Surgical, Inc) (Figure 1). 16 Measurements were taken from 6-week postoperative AP pelvic radiographs by two independent reviewers after conducting an interobserver reliability analysis. Secondary outcomes included complications such as dislocation, prosthetic joint infection, and other medical complications.…”

Achieving Precise Cup Positioning in Direct Anterior Total Hip Arthroplasty: A Narrative Review

“…The workstation computes the relationship between the trackers and the camera and inclination and anteversion are shown on the monitor in real time [ 56 ]. The system has shown to be accurate and precise [ 57 ]. Comparing intraoperative measurements to postoperative radiographs, 93% of the cups anteversion and inclination were within 10° of the intraoperative measurement [ 58 ].…”

The Hip-spine Assessment of a Novel Surgical Planning Software Provides Acetabular Component Targets That Are Reliable and in Agreement With Current Clinical Recommendations

“…Most existing planning options that incorporate spinopelvic mobility require computed tomography or magnetic resonance imaging, are implant or device-specific, are performed elsewhere by engineers, or are limited to measuring angles on a single image at a time. A novel surgical planning software [ 14 ] has recently been released as an easy-to-use, implant-agnostic, surgeon-controlled templating and planning solution that only requires x-rays to incorporate the hip-spine relationship to plan patient-specific cup targets for hip arthroplasty. The novel surgical planning software requires the user to measure pelvic obliquity, anterior plane pelvic tilt (APPt), and sacral slope on standing and sitting lateral images to provide a suggested cup target.…”

“…The novel surgical planning software requires the user to measure pelvic obliquity, anterior plane pelvic tilt (APPt), and sacral slope on standing and sitting lateral images to provide a suggested cup target. The novel software provides measurements to the same accuracy and precision as TraumaCad [ 14 ], but there is still a need to examine the clinical validity of the patient-specific functional cup targets. Different research groups have proposed various methods of performing hip-spine analyses [ [15] , [16] , [17] ], but the most frequently used is the change in sacral slope value from standing to relaxed sitting (delta sacral slope [dSS]) and the difference between pelvic incidence and lumbar lordosis (PI-LL mismatch).…”