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Published in: International Orthopaedics 3/2009

01-06-2009 | Original Paper

Computer navigation in total hip replacement: a meta-analysis

Authors: Rajiv Gandhi, Anthony Marchie, Forough Farrokhyar, Nizar Mahomed

Published in: International Orthopaedics | Issue 3/2009

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Abstract

Proponents of navigated hip arthroplasty have suggested that it may increase the precision of acetabular component placement. We conducted a systematic review and meta-analysis to evaluate the validity of this theory. We searched, in duplicate, MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials for randomised trials comparing the use of computer navigation with the freehand technique for acetabular cup placement within the desired alignment. We assessed the methodological quality of the studies and abstracted the relevant data. Tests of heterogeneity and publication bias were performed. From the three studies included, there was no evidence of heterogeneity between studies. A total of 250 patients were entered into the analysis. The beneficial odds ratio for the number of outliers was 0.285 (95% confidence interval [CI]: 0.143 to 0.569; p < 0.001). We conclude that navigation in hip arthroplasty improves the precision of acetabular cup placement by decreasing the number of outliers from the desired alignment.
Literature
1.
go back to reference Del Schutte H Jr, Lipman AJ, Bannar SM, Livermore JT, Ilstrup D, Morrey BF (1998) Effects of acetabular abduction on cup wear rates in total hip arthroplasty. J Arthroplasty 13:621–626PubMedCrossRef Del Schutte H Jr, Lipman AJ, Bannar SM, Livermore JT, Ilstrup D, Morrey BF (1998) Effects of acetabular abduction on cup wear rates in total hip arthroplasty. J Arthroplasty 13:621–626PubMedCrossRef
2.
go back to reference DiGioia AM 3rd, Jaramaz B, Plakseychuk AY, Moody JE Jr, Nikou C, Labarca RS, Levison TJ, Picard F (2002) Comparison of a mechanical acetabular alignment guide with computer placement of the socket. J Arthroplasty 17:359–364PubMedCrossRef DiGioia AM 3rd, Jaramaz B, Plakseychuk AY, Moody JE Jr, Nikou C, Labarca RS, Levison TJ, Picard F (2002) Comparison of a mechanical acetabular alignment guide with computer placement of the socket. J Arthroplasty 17:359–364PubMedCrossRef
3.
go back to reference DiGioia AM 3rd, Plakseychuk AY, Levison TJ, Jaramaz B (2003) Mini-incision technique for total hip arthroplasty with navigation. J Arthroplasty 18:123–128PubMedCrossRef DiGioia AM 3rd, Plakseychuk AY, Levison TJ, Jaramaz B (2003) Mini-incision technique for total hip arthroplasty with navigation. J Arthroplasty 18:123–128PubMedCrossRef
4.
go back to reference Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315:629–634PubMed Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315:629–634PubMed
5.
go back to reference Haaker RG, Tiedjen K, Ottersbach A, Rubenthaler F, Stockheim M, Stiehl JB (2007) Comparison of conventional versus computer-navigated acetabular component insertion. J Arthroplasty 22:151–159PubMedCrossRef Haaker RG, Tiedjen K, Ottersbach A, Rubenthaler F, Stockheim M, Stiehl JB (2007) Comparison of conventional versus computer-navigated acetabular component insertion. J Arthroplasty 22:151–159PubMedCrossRef
6.
go back to reference Jolles BM, Genoud P, Hoffmeyer P (2004) Computer-assisted cup placement techniques in total hip arthroplasty improve accuracy of placement. Clin Orthop Relat Res 426:174–179PubMedCrossRef Jolles BM, Genoud P, Hoffmeyer P (2004) Computer-assisted cup placement techniques in total hip arthroplasty improve accuracy of placement. Clin Orthop Relat Res 426:174–179PubMedCrossRef
7.
go back to reference Kalteis T, Handel M, Bäthis H, Perlick L, Tingart M, Grifka A (2006) Imageless navigation for insertion of the acetabular component in total hip arthroplasty: is it as accurate as CT-based navigation? J Bone Joint Surg Br 88(2):163–167PubMedCrossRef Kalteis T, Handel M, Bäthis H, Perlick L, Tingart M, Grifka A (2006) Imageless navigation for insertion of the acetabular component in total hip arthroplasty: is it as accurate as CT-based navigation? J Bone Joint Surg Br 88(2):163–167PubMedCrossRef
8.
go back to reference Kennedy JG, Rogers WB, Soffe KE, Sullivan RJ, Griffen DG, Sheehan LJ (1998) Effect of acetabular component orientation on recurrent dislocation, pelvic osteolysis, polyethylene wear, and component migration. J Arthroplasty 13:530–534PubMedCrossRef Kennedy JG, Rogers WB, Soffe KE, Sullivan RJ, Griffen DG, Sheehan LJ (1998) Effect of acetabular component orientation on recurrent dislocation, pelvic osteolysis, polyethylene wear, and component migration. J Arthroplasty 13:530–534PubMedCrossRef
9.
go back to reference Leenders T, Vandevelde D, Mahieu G, Nuyts R (2002) Reduction in variability of acetabular cup abduction using computer assisted surgery: a prospective and randomized study. Comput Aided Surg 7:99–106PubMedCrossRef Leenders T, Vandevelde D, Mahieu G, Nuyts R (2002) Reduction in variability of acetabular cup abduction using computer assisted surgery: a prospective and randomized study. Comput Aided Surg 7:99–106PubMedCrossRef
10.
go back to reference Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR (1978) Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am 60:217–220PubMed Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR (1978) Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am 60:217–220PubMed
11.
go back to reference Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF (1999) Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Quality of Reporting of Meta-analyses. Lancet 354:1896–1900PubMedCrossRef Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF (1999) Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Quality of Reporting of Meta-analyses. Lancet 354:1896–1900PubMedCrossRef
12.
go back to reference Murphy SB, Ecker TM, Tannast M (2006) THA performed using conventional and navigated tissue-preserving techniques. Clin Orthop Relat Res 453:160–167PubMedCrossRef Murphy SB, Ecker TM, Tannast M (2006) THA performed using conventional and navigated tissue-preserving techniques. Clin Orthop Relat Res 453:160–167PubMedCrossRef
13.
go back to reference Parratte S, Argenson JN (2007) Validation and usefulness of a computer-assisted cup-positioning system in total hip arthroplasty. A prospective, randomized, controlled study. J Bone Joint Surg Am 89:494–499PubMedCrossRef Parratte S, Argenson JN (2007) Validation and usefulness of a computer-assisted cup-positioning system in total hip arthroplasty. A prospective, randomized, controlled study. J Bone Joint Surg Am 89:494–499PubMedCrossRef
14.
go back to reference Paterno SA, Lachiewicz PF, Kelley SS (1997) The influence of patient-related factors and the position of the acetabular component on the rate of dislocation after total hip replacement. J Bone Joint Surg Am 79:1202–1210PubMed Paterno SA, Lachiewicz PF, Kelley SS (1997) The influence of patient-related factors and the position of the acetabular component on the rate of dislocation after total hip replacement. J Bone Joint Surg Am 79:1202–1210PubMed
15.
go back to reference Sugano N, Nishii T, Miki H, Yoshikawa H, Sato Y, Tamura S (2007) Mid-term results of cementless total hip replacement using a ceramic-on-ceramic bearing with and without computer navigation. J Bone Joint Surg Br 89(4):455–460PubMedCrossRef Sugano N, Nishii T, Miki H, Yoshikawa H, Sato Y, Tamura S (2007) Mid-term results of cementless total hip replacement using a ceramic-on-ceramic bearing with and without computer navigation. J Bone Joint Surg Br 89(4):455–460PubMedCrossRef
16.
go back to reference Weil Y, Mattan Y, Kandel L, Eisenberg O, Liebergall M (2006) Navigation-assisted minimally invasive two-incision total hip arthoplasty. Orthopedics 29(3):200–206PubMed Weil Y, Mattan Y, Kandel L, Eisenberg O, Liebergall M (2006) Navigation-assisted minimally invasive two-incision total hip arthoplasty. Orthopedics 29(3):200–206PubMed
17.
go back to reference Wixson RL, MacDonald MA (2005) Total hip arthroplasty through a minimal posterior approach using imageless computer-assisted hip navigation. J Arthroplasty 20 (7 Suppl 3):51–56PubMedCrossRef Wixson RL, MacDonald MA (2005) Total hip arthroplasty through a minimal posterior approach using imageless computer-assisted hip navigation. J Arthroplasty 20 (7 Suppl 3):51–56PubMedCrossRef
Metadata
Title
Computer navigation in total hip replacement: a meta-analysis
Authors
Rajiv Gandhi
Anthony Marchie
Forough Farrokhyar
Nizar Mahomed
Publication date
01-06-2009
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 3/2009
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-008-0539-6

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