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Accuracy of Acetabular Component Positioning Using Computer-assisted Navigation in Direct Anterior Total Hip Arthroplasty

Background  Appropriate component positioning in total hip arthroplasty (THA) is imperative for long-term survivorship. C-arm fluoroscopy provides visual guidance in the direct anterior approach (DAA), but it is limited by qualitative properties. Conversely, imageless computer-assisted navigation sy...

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Autores principales: Bradley, Michael P, Benson, Jessica R., Muir, Jeffrey M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6579332/
https://www.ncbi.nlm.nih.gov/pubmed/31249755
http://dx.doi.org/10.7759/cureus.4478
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author Bradley, Michael P
Benson, Jessica R.
Muir, Jeffrey M
author_facet Bradley, Michael P
Benson, Jessica R.
Muir, Jeffrey M
author_sort Bradley, Michael P
collection PubMed
description Background  Appropriate component positioning in total hip arthroplasty (THA) is imperative for long-term survivorship. C-arm fluoroscopy provides visual guidance in the direct anterior approach (DAA), but it is limited by qualitative properties. Conversely, imageless computer-assisted navigation systems (CAS) provide surgeons with intraoperative, three-dimensional (3D) quantitative measurements for cup position, although the accuracy of such systems has not been extensively addressed in the DAA. We evaluated the ability of an imageless CAS to deliver measurements for acetabular cup position with accuracy in the DAA. Materials and methods  A retrospective analysis of 69 primary THA procedures was conducted. Acetabular cup position measurements (anteversion and inclination) obtained intraoperatively by imageless navigation were compared to standard, postoperative anteroposterior pelvic radiographic measurements. Statistical comparisons were made using the Bland-Altman technique. Results  The mean difference between device and radiographic measurements for anteversion was 3.4° (standard deviation (SD): 4.1°; absolute mean difference (ABS): 4.2°), and 4.0° for inclination (SD: 3.6°; ABS: 4.3°). Bland-Altman analysis demonstrated excellent agreement; 93% (64/69) and 97% (67/69) of anteversion pairings fell within the statistical and clinical limits of agreement, whereas 94% (65/69) and 100% (69/69) of inclination pairings were within the statistical and clinical limits, respectively. Conclusions  Measurements obtained intraoperatively for acetabular cup position using imageless navigation in the DAA are agreeable with the current clinical standard.
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spelling pubmed-65793322019-06-27 Accuracy of Acetabular Component Positioning Using Computer-assisted Navigation in Direct Anterior Total Hip Arthroplasty Bradley, Michael P Benson, Jessica R. Muir, Jeffrey M Cureus Orthopedics Background  Appropriate component positioning in total hip arthroplasty (THA) is imperative for long-term survivorship. C-arm fluoroscopy provides visual guidance in the direct anterior approach (DAA), but it is limited by qualitative properties. Conversely, imageless computer-assisted navigation systems (CAS) provide surgeons with intraoperative, three-dimensional (3D) quantitative measurements for cup position, although the accuracy of such systems has not been extensively addressed in the DAA. We evaluated the ability of an imageless CAS to deliver measurements for acetabular cup position with accuracy in the DAA. Materials and methods  A retrospective analysis of 69 primary THA procedures was conducted. Acetabular cup position measurements (anteversion and inclination) obtained intraoperatively by imageless navigation were compared to standard, postoperative anteroposterior pelvic radiographic measurements. Statistical comparisons were made using the Bland-Altman technique. Results  The mean difference between device and radiographic measurements for anteversion was 3.4° (standard deviation (SD): 4.1°; absolute mean difference (ABS): 4.2°), and 4.0° for inclination (SD: 3.6°; ABS: 4.3°). Bland-Altman analysis demonstrated excellent agreement; 93% (64/69) and 97% (67/69) of anteversion pairings fell within the statistical and clinical limits of agreement, whereas 94% (65/69) and 100% (69/69) of inclination pairings were within the statistical and clinical limits, respectively. Conclusions  Measurements obtained intraoperatively for acetabular cup position using imageless navigation in the DAA are agreeable with the current clinical standard. Cureus 2019-04-16 /pmc/articles/PMC6579332/ /pubmed/31249755 http://dx.doi.org/10.7759/cureus.4478 Text en Copyright © 2019, Bradley et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Orthopedics
Bradley, Michael P
Benson, Jessica R.
Muir, Jeffrey M
Accuracy of Acetabular Component Positioning Using Computer-assisted Navigation in Direct Anterior Total Hip Arthroplasty
title Accuracy of Acetabular Component Positioning Using Computer-assisted Navigation in Direct Anterior Total Hip Arthroplasty
title_full Accuracy of Acetabular Component Positioning Using Computer-assisted Navigation in Direct Anterior Total Hip Arthroplasty
title_fullStr Accuracy of Acetabular Component Positioning Using Computer-assisted Navigation in Direct Anterior Total Hip Arthroplasty
title_full_unstemmed Accuracy of Acetabular Component Positioning Using Computer-assisted Navigation in Direct Anterior Total Hip Arthroplasty
title_short Accuracy of Acetabular Component Positioning Using Computer-assisted Navigation in Direct Anterior Total Hip Arthroplasty
title_sort accuracy of acetabular component positioning using computer-assisted navigation in direct anterior total hip arthroplasty
topic Orthopedics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6579332/
https://www.ncbi.nlm.nih.gov/pubmed/31249755
http://dx.doi.org/10.7759/cureus.4478
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