Skip to main content
Top
Published in: International Orthopaedics 1/2012

01-01-2012 | Original Paper

Validation of navigation assisted cup placement in total hip arthroplasty

Authors: M. Ajith Kumar, M. Shantharam Shetty, Kanthi G. Kiran, Abhishek R. Kini

Published in: International Orthopaedics | Issue 1/2012

Login to get access

Abstract

Purpose

Computer navigation has the potential to provide precise intraoperative knowledge to the surgeon. Previous studies with navigation have confirmed its function for improved component position but few studies have reported the accuracy and precision of navigation system in clinical use. With this study we propose to evaluate the efficacy of navigation in guiding cup placement.

Methods

Fifty-six patients undergoing primary total hip arthroplasty were prospectively included in this study. Stryker imageless navigation system which is accurate to 0.5° was used in all cases. Intraoperative data was collected for the acetabular component position using navigation for the freehand cup placement and the final cup placement done using navigation. Postoperative evaluation of component position was done with computed tomography (CT) and the deviation from intraoperative freehand and navigation values were calculated.

Results

The mean inclination of the freehand reading was 39.5° (range, 20°–58°), mean version of freehand reading was 10.7° (−6°– 27°), and the mean navigation reading was 43.2° (37°–49°) for inclination and 13.0° (−8° – 24°) for version. On postoperative CT scan analysis the mean inclination was 45.3° (34°–56°) and mean version was 15.1° (4°–25°). The deviation of the freehand inclination from the post operative CT scan reading was 11.4° (1°–30°) and the version deviated by a mean of 10.8° (2°–26°). The deviation of the navigation reading from the CT scan reading had a mean of 5.3° (1°–13°) for inclination and 5.6° (1°–17°) for version.

Conclusion

The accuracy of the navigation system over conventional freehand cup placement is validated by this study.
Literature
1.
go back to reference Digioia AM 3rd, Jaramaz B, Plakseychuk AY, Moody JE, 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, 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
2.
go back to reference Barrack RL, Lavernia C, Ries M, Thornberry R, Tozakoglou E (2001) Virtual reality computer animation of the effect of component position and design on stability after total hip arthroplasty. Orthop Clin North Am 32:569–577, viiPubMedCrossRef Barrack RL, Lavernia C, Ries M, Thornberry R, Tozakoglou E (2001) Virtual reality computer animation of the effect of component position and design on stability after total hip arthroplasty. Orthop Clin North Am 32:569–577, viiPubMedCrossRef
3.
go back to reference Charnley J, Cupic Z (1973) The nine and ten year results of the low friction arthroplasty of the hip. Clin Orthop Relat Res 95:9–25PubMed Charnley J, Cupic Z (1973) The nine and ten year results of the low friction arthroplasty of the hip. Clin Orthop Relat Res 95:9–25PubMed
4.
go back to reference D’Lima DD, Urquhart AG, Buehler KO, Walker RH, Colwell CW Jr (2000) The effect of the orientation of the acetabular and femoral components on the range of motion of the hip at different head-neck ratios. J Bone Joint Surg Am 82:315–321PubMed D’Lima DD, Urquhart AG, Buehler KO, Walker RH, Colwell CW Jr (2000) The effect of the orientation of the acetabular and femoral components on the range of motion of the hip at different head-neck ratios. J Bone Joint Surg Am 82:315–321PubMed
5.
go back to reference Scifert CF, Brown TD, Pedersen DR, Callaghan JJ (1998) A finite element analysis of factors influencing total hip dislocation. Clin Orthop Relat Res 355:152–162PubMedCrossRef Scifert CF, Brown TD, Pedersen DR, Callaghan JJ (1998) A finite element analysis of factors influencing total hip dislocation. Clin Orthop Relat Res 355:152–162PubMedCrossRef
6.
go back to reference Yamaguchi M, Akisue T, Bauer TW, Hashimoto Y (2000) The spatial location of impingement in total hip arthroplasty. J Arthroplasty 15:305–313PubMedCrossRef Yamaguchi M, Akisue T, Bauer TW, Hashimoto Y (2000) The spatial location of impingement in total hip arthroplasty. J Arthroplasty 15:305–313PubMedCrossRef
7.
go back to reference Jaramaz B, DiGioia AM 3rd, Blackwell M, Nikou C (1998) Computer assisted measurement of cup placement in total hip replacement. Clin Orthop Relat Res 354:70–81PubMedCrossRef Jaramaz B, DiGioia AM 3rd, Blackwell M, Nikou C (1998) Computer assisted measurement of cup placement in total hip replacement. Clin Orthop Relat Res 354:70–81PubMedCrossRef
8.
go back to reference Tannast M, Langlotz U, Siebenrock KA, Wiese M, Bernsmann K, Langlotz F (2005) Anatomic referencing of cup orientation in total hip arthroplasty. Clin Orthop Relat Res 436:144–150PubMedCrossRef Tannast M, Langlotz U, Siebenrock KA, Wiese M, Bernsmann K, Langlotz F (2005) Anatomic referencing of cup orientation in total hip arthroplasty. Clin Orthop Relat Res 436:144–150PubMedCrossRef
9.
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
10.
go back to reference Kalteis T, Handel M, Herold T, Perlick L, Baethis H, Grifka J (2005) Greater accuracy in positioning of the acetabular cup by using an image-free navigation system. Int Orthop 29:272–276PubMedCrossRef Kalteis T, Handel M, Herold T, Perlick L, Baethis H, Grifka J (2005) Greater accuracy in positioning of the acetabular cup by using an image-free navigation system. Int Orthop 29:272–276PubMedCrossRef
11.
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
12.
go back to reference Nogler M, Kessler O, Prassl A, Donnelly B, Streicher R, Sledge JB, Krismer M (2004) Reduced variability of acetabular cup positioning with use of an imageless navigation system. Clin Orthop Relat Res 426:159–163PubMedCrossRef Nogler M, Kessler O, Prassl A, Donnelly B, Streicher R, Sledge JB, Krismer M (2004) Reduced variability of acetabular cup positioning with use of an imageless navigation system. Clin Orthop Relat Res 426:159–163PubMedCrossRef
13.
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
14.
go back to reference McCollum DE, Gray WJ (1990) Dislocation after total hip arthroplasty. Causes and prevention. Clin Orthop Relat Res 261:159–170PubMed McCollum DE, Gray WJ (1990) Dislocation after total hip arthroplasty. Causes and prevention. Clin Orthop Relat Res 261:159–170PubMed
15.
go back to reference Ng Fu Yuen, Zhang JT, Chiu KY, Yan CH (2011) A cadaveric study of posterior dislocation after total hip replacement—effects of head diameter and acetabular anteversion. Int Orthop 35(3):325–329PubMedCrossRef Ng Fu Yuen, Zhang JT, Chiu KY, Yan CH (2011) A cadaveric study of posterior dislocation after total hip replacement—effects of head diameter and acetabular anteversion. Int Orthop 35(3):325–329PubMedCrossRef
16.
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
17.
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 Arthroplast 13:530–534CrossRef 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 Arthroplast 13:530–534CrossRef
18.
go back to reference Saxler G, Marx A, Vandevelde D, Langlotz U, Tannast M, Wiese M, Michaelis U, Kemper G, Grutzner PA, Steffen R, von Knoch M, Holland-Letz T, Bernsmann K (2004) The accuracy of free-hand cup positioning—a CT based measurement of cup placement in 105 total hip arthroplasties. Int Orthop 28:198–201PubMedCrossRef Saxler G, Marx A, Vandevelde D, Langlotz U, Tannast M, Wiese M, Michaelis U, Kemper G, Grutzner PA, Steffen R, von Knoch M, Holland-Letz T, Bernsmann K (2004) The accuracy of free-hand cup positioning—a CT based measurement of cup placement in 105 total hip arthroplasties. Int Orthop 28:198–201PubMedCrossRef
19.
go back to reference Moskal JT, Capps SG (2010) Improving the accuracy of acetabular component orientation: avoiding malposition. J Am Acad Orthop Surg 18:286–296PubMed Moskal JT, Capps SG (2010) Improving the accuracy of acetabular component orientation: avoiding malposition. J Am Acad Orthop Surg 18:286–296PubMed
20.
go back to reference Archbold HA, Mockford B, Molloy D, McConway J, Ogonda L, Beverland D (2006) The transverse acetabular ligament: An aid to orientation of the acetabular component during primary total hip replacement. A preliminary study of cases investigating postoperative stability. J Bone Joint Surg Br 88:883–886PubMedCrossRef Archbold HA, Mockford B, Molloy D, McConway J, Ogonda L, Beverland D (2006) The transverse acetabular ligament: An aid to orientation of the acetabular component during primary total hip replacement. A preliminary study of cases investigating postoperative stability. J Bone Joint Surg Br 88:883–886PubMedCrossRef
21.
go back to reference Maruyama M, Feinberg JR, Capello WN, D’Antonio JA (2001) The Frank Stinchfield Award: Morphologic features of the acetabulum and femur. Anteversion angle and implant positioning. Clin Orthop Relat Res 393:52–65PubMedCrossRef Maruyama M, Feinberg JR, Capello WN, D’Antonio JA (2001) The Frank Stinchfield Award: Morphologic features of the acetabulum and femur. Anteversion angle and implant positioning. Clin Orthop Relat Res 393:52–65PubMedCrossRef
22.
go back to reference Dorr LD, Malik A, Wan Z, Long WT, Harris M (2007) Precision and bias of imageless computer navigation and surgeon estimates for acetabular component position. Clin Orthop Relat Res 465:92–99PubMed Dorr LD, Malik A, Wan Z, Long WT, Harris M (2007) Precision and bias of imageless computer navigation and surgeon estimates for acetabular component position. Clin Orthop Relat Res 465:92–99PubMed
23.
go back to reference Bosker BH, Verheyen PM, Horstmann WG, Tulp NJA (2007) Poor accuracy of freehand cup positioning during total hip arthroplasty. Arch Orthop Trauma Surg 127:375–379PubMedCrossRef Bosker BH, Verheyen PM, Horstmann WG, Tulp NJA (2007) Poor accuracy of freehand cup positioning during total hip arthroplasty. Arch Orthop Trauma Surg 127:375–379PubMedCrossRef
Metadata
Title
Validation of navigation assisted cup placement in total hip arthroplasty
Authors
M. Ajith Kumar
M. Shantharam Shetty
Kanthi G. Kiran
Abhishek R. Kini
Publication date
01-01-2012
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 1/2012
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-011-1268-9

Other articles of this Issue 1/2012

International Orthopaedics 1/2012 Go to the issue