Simon D Steppacher1, Jens H Kowal, Stephen Barry Murphy. 1. Center for Computer Assisted and Reconstructive Surgery, New England Baptist Hospital, Tufts University School of Medicine, 125 Parker Hill Avenue, Suite 545, Boston, MA 02120, USA.
Abstract
BACKGROUND: Although surgical navigation reduces the rate of malpositioned acetabular cups in total hip arthroplasty (THA), its use has not been widely adopted. As a result of our perceived need for simple and efficient methods of navigation, we developed a mechanical navigation device for acetabular cup orientation. QUESTIONS/PURPOSES: We assessed accuracy of cup orientation (mean error of cup inclination and anteversion) of a novel mechanical navigation device, percentage of outliers, length of operation, and compared the results with a series of CT-based computer-assisted THAs. METHODS: Cup orientation of 70 THAs performed using the mechanical navigation device was compared with a historical control group of 146 THAs performed using CT-based computer navigation. Postoperative cup orientation was measured using a validated two-dimensional/three-dimensional matching method. An outlier was defined outside a range of ± 10° from the planned inclination and/or anteversion. RESULTS: Using the mechanical navigation device, we observed a decrease in the errors of inclination (1.3° ± 3.4° [range, -6.6° to 8.2°] versus 3.5° ± 4.2° [-12.7° to 6.9°]), errors of anteversion (1.0° ± 4.1° [-8.8° to 9.5°] versus 3.0° ± 5.8° [-11.8° to 19.6°]), percentages of outliers (0% versus 9.6%), and length of operation (112 ± 22 [78-184] minutes versus 132 ± 18 [90-197] minutes) compared with CT-based navigation. CONCLUSIONS: Compared with CT-based surgical navigation, navigation of acetabular cup orientation using a mechanical device can be performed in less time, lower mean errors, and minimal equipment.
BACKGROUND: Although surgical navigation reduces the rate of malpositioned acetabular cups in total hip arthroplasty (THA), its use has not been widely adopted. As a result of our perceived need for simple and efficient methods of navigation, we developed a mechanical navigation device for acetabular cup orientation. QUESTIONS/PURPOSES: We assessed accuracy of cup orientation (mean error of cup inclination and anteversion) of a novel mechanical navigation device, percentage of outliers, length of operation, and compared the results with a series of CT-based computer-assisted THAs. METHODS: Cup orientation of 70 THAs performed using the mechanical navigation device was compared with a historical control group of 146 THAs performed using CT-based computer navigation. Postoperative cup orientation was measured using a validated two-dimensional/three-dimensional matching method. An outlier was defined outside a range of ± 10° from the planned inclination and/or anteversion. RESULTS: Using the mechanical navigation device, we observed a decrease in the errors of inclination (1.3° ± 3.4° [range, -6.6° to 8.2°] versus 3.5° ± 4.2° [-12.7° to 6.9°]), errors of anteversion (1.0° ± 4.1° [-8.8° to 9.5°] versus 3.0° ± 5.8° [-11.8° to 19.6°]), percentages of outliers (0% versus 9.6%), and length of operation (112 ± 22 [78-184] minutes versus 132 ± 18 [90-197] minutes) compared with CT-based navigation. CONCLUSIONS: Compared with CT-based surgical navigation, navigation of acetabular cup orientation using a mechanical device can be performed in less time, lower mean errors, and minimal equipment.
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