Sima Zakani1, John F Rudan2, Randy E Ellis3. 1. Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada. szakani@mail.ubc.ca. 2. Department of Surgery, Queen's University, Kingston, ON, Canada. 3. School of Computing, Department of Mechanical and Materials Engineering, Department of Surgery, Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada.
Abstract
PURPOSE: An optoelectronic surgical navigation system was used to detect small but measurable translational motion of human hip cadavers in high-range passive motions. Kinematic data were also examined to demonstrate the role of soft tissues in constraining hip translation. METHODS: Twelve cadaver hips were scanned using CT, instrumented for navigation, and passively taken through motion assessment. Center of the femoral head was tracked in the acetabular coordinates. Maximum non-impinging translation of the femoral head for each specimen hip was reported. This was repeated for 5 tissue states: whole, exposed to the capsule, partially or fully incised capsule, resection of the ligamentum teres and labrectomy. Femoral motions were compared to the reported value for ideal ball and socket model. RESULTS: Whole and exposed hips underwent maximal translations of [Formula: see text] and [Formula: see text] mm, respectively. These translational motions were statistically significantly different from reported value for a purely spherical joint, [Formula: see text]. Further tissue removal almost always significantly increased maximum non-impingement translational motion with [Formula: see text]. CONCLUSION: We found subtle but definite translations in every cadaver hip. There was no consistent pattern of translation. It is possible to use the surgical navigation systems for the assessment of human hip kinematics intra-operatively and improve the treatment of total hip arthroplasty patients by the knowledge of the fact that their hips translate. Better procedure selection and implantation optimization may arise from improved understanding of the motion of this critically important human joint.
PURPOSE: An optoelectronic surgical navigation system was used to detect small but measurable translational motion of human hip cadavers in high-range passive motions. Kinematic data were also examined to demonstrate the role of soft tissues in constraining hip translation. METHODS: Twelve cadaver hips were scanned using CT, instrumented for navigation, and passively taken through motion assessment. Center of the femoral head was tracked in the acetabular coordinates. Maximum non-impinging translation of the femoral head for each specimen hip was reported. This was repeated for 5 tissue states: whole, exposed to the capsule, partially or fully incised capsule, resection of the ligamentum teres and labrectomy. Femoral motions were compared to the reported value for ideal ball and socket model. RESULTS: Whole and exposed hips underwent maximal translations of [Formula: see text] and [Formula: see text] mm, respectively. These translational motions were statistically significantly different from reported value for a purely spherical joint, [Formula: see text]. Further tissue removal almost always significantly increased maximum non-impingement translational motion with [Formula: see text]. CONCLUSION: We found subtle but definite translations in every cadaver hip. There was no consistent pattern of translation. It is possible to use the surgical navigation systems for the assessment of human hip kinematics intra-operatively and improve the treatment of total hip arthroplastypatients by the knowledge of the fact that their hips translate. Better procedure selection and implantation optimization may arise from improved understanding of the motion of this critically important human joint.
Entities:
Keywords:
Aspherical hip; Hip translations; Surgical navigation
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