Computer Navigation vs. Conventional Overlay Methods in Direct Anterior Total Hip Arthroplasty: A Single Surgeon Experience

Background: The use of computer navigation (CN) is expanding in direct anterior (DA) total hip arthroplasty (THA). In this study, we investigated the use of a noninvasive, fluoroscopic-based, CN technology suite on operative outcomes in a single surgeon DA THA practice. Hypothesis: Computer-navigated DA THA decreases leg length discrepancy (LLD) variation and fluoroscopic radiation dose without adding operative time compared to the traditional overlay (OL) technique. Methods: A retrospective review was performed on a total of 109 primary DA THA patients, with 58 in the CN and 51 in the OL group. Outcome metrics were postoperative LLD, radiation dose per case, and operative time. Statistical analysis was completed with Mann-Whitney U tests for differences between the means for LLD, radiation dose, and operative time. Results: No difference was observed in postoperative LLD between the CN (average: 1.8 mm) and OL (average: 1.9 mm) groups (p = 0.458). A significant reduction in average radiation dose (mGy) per case within the CN group (8.17 ± 6.09 mGy) compared to the OL group (13.17 ± 7.75 mGy) (p < 0.02) was observed. The average operative time in the CN group was 80 ± 18 minutes compared to 120 ± 32 minutes in the OL group (p < 0.01). Conclusion: There was no difference in LLD between the two groups. The addition of CN into a DA THA practice decreased both average radiation dose and operative time when compared to the standard OL technique.