Abstract
Background
This study aimed to elucidate the accuracy of cup placement with the computed tomography
(CT)-based navigation system (CTN) in the direct anterior approach (DAA)-total hip
arthroplasty (THA) in the supine position compared with the mechanical cup alignment
guide (MG) or the fluoroscopy (FS).
Methods
A total of 171 hips of 156 patients undergone primary THA were classified into the
following three groups (the MG group: 63 hips, the FS group: 58 hips, the CTN group:
50 hips). Comparing the preoperative planning with postoperative CT measurement by
three-dimensional templating software, the accuracy of cup placement was investigated
in the three groups.
Results
There were significant differences in the mean absolute error of radiographic inclination
(RI) between the MG group (4.4° ± 3.2°) and the CTN group (2.8° ± 2.5°) (p = 0.01). The mean absolute error of radiographic anteversion (RA) also showed significant
differences between the CTN group (2.8° ± 1.9°) and the MG group (5.8° ± 4.7°) (p = 0.0001) or the FS group (4.8° ± 4.1°) (p = 0.02). Regarding the cup center position, the mean absolute error of vertical position
from preoperative planning was the smallest in the CTN group (1.8 ± 1.4 mm) compared
with those in other groups (MG: 3.3 ± 3.2 mm, p = 0.007, FS: 3.2 ± 3.0 mm, p = 0.017).
Conclusion
The CTN guarantees accurate cup placement in the DAA-THA in the supine position compared
with the MG and FS groups.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Orthopaedic ScienceAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The operation of the century: total hip replacement.Lancet. 2007 Oct 27; 370: 1508-1519
- Incidence rates of dislocation, pulmonary embolism, and deep infection during the first six months after elective total hip replacement.J Bone Joint Surg Am. 2003 Jan; 85: 20-26
- Periprosthetic femoral fractures classification and demographics of 1049 periprosthetic femoral fractures from the Swedish National Hip Arthroplasty Register.J Arthroplasty. 2005 Oct; 20: 857-865
- Prevention of dislocation after total hip arthroplasty.J Arthroplasty. 2018 May; 33: 1316-1324
- Redefining the acetabular component safe zone for posterior approach total hip arthroplasty.J Arthroplasty. 2016 Feb; 31: 506-511
- Compliant positioning of total hip components for optimal range of motion.J Orthop Res. 2004 Jul; 22: 815-821
- Effects of hip center location on the moment-generating capacity of the muscles.J Biomech. 1993 Apr-May; 26: 485-499
- Anterior and anterolateral approaches for THA are associated with lower dislocation risk without higher revision risk.Clin Orthop Relat Res. 2015 Nov; 473: 3401-3408
- A clinical comparative study of the direct anterior with mini-posterior approach: two consecutive series.J Arthroplasty. 2009 Aug; 24: 698-704
- Comparison of a mechanical acetabular alignment guide with computer placement of the socket.J Arthroplasty. 2002 Apr; 17: 359-364
- The use of fluoroscopy during direct anterior hip arthroplasty: powerful or misleading?.J Arthroplasty. 2018 Jun; 33: 1775-1779
- Computer-assisted orthopaedic surgery and robotic surgery in total hip arthroplasty.Clin Orthop Surg. 2013 Mar; 5: 1-9
- Comparison of accuracy of cup position using portable navigation versus alignment guide in total hip arthroplasty in supine position.Hip Int. 2021 Jul; 31: 492-499
- Accuracy of angle and position of the cup using computed tomography-based navigation systems in total hip arthroplasty.Comput Aided Surg. 2013; 18: 187-194
- Single-incision anterior approach for total hip arthroplasty on an orthopaedic table.Clin Orthop Relat Res. 2005 Dec; 441: 115-124
- Total hip arthroplasty using imageless computer-assisted hip navigation: a prospective randomized study.J Arthroplasty. 2014 Apr; 29: 786-791
- Accuracy and potential pitfalls of fluoroscopy-guided acetabular cup placement.Comput Aided Surg. 2005 Sep-Nov; 10: 329-336
- The accuracy of a mechanical cup alignment guide in total hip arthroplasty (THA) through direct anterior and posterior approaches measured with CT-based navigation.J Arthroplasty. 2015 Sep; 30: 1561-1564
- Comparison of navigation accuracy in THA between the mini-anterior and -posterior approaches.Int J Med Robot. 2009 Mar; 5: 20-25
- Efficacy of a computed tomography-based navigation system for placement of the acetabular component in total hip arthroplasty for developmental dysplasia of the hip.J Orthop Surg (Hong Kong). 2017 Sep-Dec; 25 (2309499017727954)
- 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. 2006 Feb; 88: 163
Article info
Publication history
Published online: November 23, 2021
Accepted:
October 31,
2021
Received in revised form:
September 23,
2021
Received:
July 26,
2021
Identification
Copyright
© 2021 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
