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Clinical Orthopaedics and Related Research®

Published in:

01-04-2009 | Original Article

Component Alignment in Hip Resurfacing Using Computer Navigation

Authors: Chris Bailey, FRCS(Tr&Orth), Rehan Gul, FRCS(Tr&Orth), Mark Falworth, FRCS(Tr&Orth), Steven Zadow, FRANZCR, Roger Oakeshott, FRACS

Published in: Clinical Orthopaedics and Related Research® | Issue 4/2009

Abstract

The use of computer navigation during hip resurfacing has been proposed to reduce the risk of a malaligned component and notching with subsequent postoperative femoral neck fracture. Femoral component malalignment and notching have been identified as the major factors associated with femoral neck fracture after hip resurfacing. We performed 37 hip resurfacing procedures using an imageless computer navigation system. Preoperatively, we generated a patient-specific computer model of the proximal femur and planned a target angle for placement of the femoral component in the coronal plane. The mean navigation angle after implantation (135.5°) correlated with the target stem-shaft angle (135.4°). After implantation, the mean stem-shaft angle of the femoral component measured by three-dimensional computed tomography (135.1°) correlated with the navigation target stem-shaft angle (135.4°). The computer navigation system generates a reliable model of the proximal femur. It allows accurate placement of the femoral component and provides precise measurement of implant alignment during hip resurfacing, thereby reducing the risk of component malpositioning and femoral neck notching.

Amstutz HC, Antoniades JT, Le Duff MJ. Results for metal-on-metal hybrid hip resurfacing for Crowe type-I and II developmental dysplasia. J Bone Joint Surg Am. 2007;89:339–346.PubMedCrossRef

Barrett AR, Davies BL, Gomes MP, Harris SJ, Henckel J, Jakopec M, Kannan V, Rodriguez y Baena FM, Cobb JP. Computer-assisted hip resurfacing surgery using the Acrobot^® navigation system. Proc Inst Mech Eng. 2007;221:773–785.CrossRef

Beaulé PE, Campbell PA, Hoke R, Dorey F. Notching of the femoral neck during resurfacing arthroplasty of the hip: a vascular study. J Bone Joint Surg Br. 2006;88:35–39.PubMedCrossRef

Beaulé PE, Dorey FJ, LeDuff M, Gruen T, Amstutz H. Risk factors affecting outcome of metal-on-metal surface arthroplasty of the hip. Clin Orthop Relat Res. 2004;418:87–93.PubMedCrossRef

Beaulé PE, Lee JL, Le Duff MJ, Amstutz H, Ebramzadeh E. Orientation of the femoral component in surface arthroplasty of the hip: a biomechanical and clinical analysis. J Bone Joint Surg Am. 2004;86:2015–2021.PubMed

Belei P, Skwara A, De La Fuente M, Schkommodau E, Fuchs S, Wirtz DC, Kämper C, Radermacher K. Fluoroscopic navigation system for hip surface replacement. Comput Aided Surg. 2007;12:160–167.PubMedCrossRef

Cobb JP, Kannan V, Brust K, Thevendran G. Navigation reduces the learning curve in resurfacing total hip arthroplasty. Clin Orthop Relat Res. 2007;463:90–97.PubMed

Daniel J, Pynsent PB, McMinn DJ. Metal-on-metal resurfacing of the hip in patients under the age of 55 years with osteoarthritis. J Bone Joint Surg Br. 2004;86:177–184.PubMedCrossRef

Davis ET, Gallie P, Macgroarty K, Waddell JP, Schemitsch E. The accuracy of image-free computer navigation in the placement of the femoral component of the Birmingham hip resurfacing. J Bone Joint Surg Br. 2007;89:557–560.PubMedCrossRef

10.

Dorr L, Malik A, Wan Z, Long WT, Harris M. Precision and bias of imageless computer navigation and surgeon estimates for acetabular component position. Clin Orthop Relat Res. 2007;465:92–99.PubMed

11.

Ecker T, Tannast M, Murphy SB. Computed tomography-based surgical navigation for hip arthroplasty. Clin Orthop Relat Res. 2007;465:100–105.PubMed

12.

Ganapathi M, Vendittoli PA, Lavigne M, Günther KP. Femoral component positioning in hip resurfacing with and without navigation. Clin Orthop Relat Res. 2008 May 17 [Epub ahead of print].

13.

Gandhi R, Marchie A, Farrokhyar F, Mahomed N. Computer navigation in total hip replacement: a meta-analysis. Int Orthop. 2008 Apr 3 [Epub ahead of print].

14.

Haaker RGA, Tiedjen K, Ottersbach A, Rubenthaler F, Stockheim M, Stiehl JB. Comparison of conventional versus computer-navigated acetabular component insertion. J Arthroplasty. 2007;22:151–159.PubMedCrossRef

15.

Hart R, Svab P, Filan P. Intraoperative navigation in hip surface arthroplasty: a radiographic comparative analysis study. Arch Orthop Trauma Surg. 2008;128:429–434.PubMedCrossRef

16.

Hodgson A, Helmy N, Masri BA, Greidanus NV, Inkpen KB, Duncan CP, Garbuz DS, Anglin C. Comparative repeatability of guide-pin positioning in computer-assisted and manual femoral head resurfacing arthroplasty. Proc Inst Mech Eng. 2007;221:713–724.

17.

Hodgson AJ, Inkpen KB, Shekhman M, Anglin C, Tonetti J, Masri BA, Duncan CP, Garbuz DS, Greidanus NV. Computer-assisted femoral head resurfacing. Comput Aided Surg. 2005;10:337–343.PubMedCrossRef

18.

Jolley MN, Salvati EA, Brown GC. Early results and complications of surface replacement of the hip. J Bone Joint Surg Am. 1982;64:366–377.PubMed

19.

Krüger S, Zambelli PY, Leyvraz PF, Jolles BM. Computer-assisted placement technique in hip resurfacing arthroplasty: improvement in accuracy? Int Orthop. 2007 Aug 24 [Epub ahead of print].

20.

Markolf KL, Amstutz HC. Mechanical strength of the femur following resurfacing and conventional hip replacement procedures. Clin Orthop Relat Res. 1980;147:170–180.PubMed

21.

Mont MA, Seyley TM, Ulrich SD, Beaule PE, Boyd HS, Grecula MJ, Goldberg VM, Kennedy WR, Marker DR, Schmalzried TP, Sparling EA, Vail TP, Amstutz HC. Effect of changing indications and techniques on total hip resurfacing. Clin Orthop Relat Res. 2007;465:63–70.PubMed

22.

Schnurr C, Michael JW, Eysel P, König DP. Imageless navigation of hip resurfacing arthroplasty increases the implant accuracy. Int Orthop. 2007 Dec 22 [Epub ahead of print].

23.

Shimmin AJ, Back D. Femoral neck fractures following Birmingham hip resurfacing. J Bone Joint Surg Br. 2005;87:463–464.PubMedCrossRef

24.

Siegle D. University of Connecticut statistics. Available at: www.gifted.uconn.edu/siegle/research/correlation/corrchrt.htm. Accessed September 3, 2007.

25.

Treacy RB, McBryde CW, Pynsent PB. Birmingham hip resurfacing arthroplasty. J Bone Joint Surg Br. 2005;87:167–170.PubMedCrossRef

26.

Ybinger T, Kumpan W. Enhanced acetabular component positioning through computer-assisted navigation. Int Orthop. 2007;31:S35–S38.PubMedCrossRef

27.

Ybinger T, Kumpan W, Hoffart HE, Muschalik B, Bullmann W, Zweymüller K. Accuracy of navigation-assisted acetabular component positioning studied by computed tomography measurements: methods and results. J Arthroplasty. 2007;22:812–817.PubMedCrossRef

Title: Component Alignment in Hip Resurfacing Using Computer Navigation
Authors: Chris Bailey, FRCS(Tr&Orth)
Rehan Gul, FRCS(Tr&Orth)
Mark Falworth, FRCS(Tr&Orth)
Steven Zadow, FRANZCR
Roger Oakeshott, FRACS
Publication date: 01-04-2009
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 4/2009
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-008-0584-x

At a glance: The STEP trials

Springer Medicine

Component Alignment in Hip Resurfacing Using Computer Navigation

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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