Accuracy of acetabular component alignment with surgical guidance systems during hip arthroplasty

Background: Navigation in total hip arthroplasty has been shown to improve acetabular positioning and can decrease the incidence of mal-positioned acetabular components. This study aimed to assess two surgical guidance systems by comparing intra-operative measurements of acetabular component inclina...

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Main Authors: Xu Joshua, Veltman Ewout S., Chai Yuan, Walter William L.
Format: Article
Language:English
Published: EDP Sciences 2023-01-01
Series:SICOT-J
Subjects:
Online Access:https://www.sicot-j.org/articles/sicotj/full_html/2023/01/sicotj230001/sicotj230001.html
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author Xu Joshua
Veltman Ewout S.
Chai Yuan
Walter William L.
author_facet Xu Joshua
Veltman Ewout S.
Chai Yuan
Walter William L.
author_sort Xu Joshua
collection DOAJ
description Background: Navigation in total hip arthroplasty has been shown to improve acetabular positioning and can decrease the incidence of mal-positioned acetabular components. This study aimed to assess two surgical guidance systems by comparing intra-operative measurements of acetabular component inclination and anteversion with a post-operative CT scan. Methods: We prospectively collected intra-operative navigation data from 102 hips receiving conventional THA or hip resurfacing arthroplasty through either a direct anterior or posterior approach. Two guidance systems were used simultaneously: an inertial navigation system (INS) and an optical navigation system (ONS). Acetabular component anteversion and inclination were measured on a post-operative CT. Results: The average age of the patients was 64 years (range: 24–92) and the average BMI was 27 kg/m2 (range 19–38). 52% had hip surgery through an anterior approach. 98% of the INS measurements and 88% of the ONS measurements were within 10° of the CT measurements. The mean (and standard deviation) of the absolute difference between the postoperative CT and the intra-operative measurements for inclination and anteversion were 3.0° (2.8) and 4.5° (3.2) respectively for the ONS, along with 2.1° (2.3) and 2.4° (2.1) respectively for the INS. There was a significantly lower mean absolute difference to CT for the INS when compared to ONS in both anteversions (p < 0.001) and inclination (p = 0.02). Conclusions: We found that both inertial and optical navigation systems allowed for adequate acetabular positioning as measured on postoperative CT, and thus provide reliable intraoperative feedback for optimal acetabular component placement. Level of Evidence: Therapeutic Level II.
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spelling doaj.art-d41bfed236a344a781aaf1726ff83cec2023-05-11T09:14:14ZengEDP SciencesSICOT-J2426-88872023-01-0191210.1051/sicotj/2023010sicotj230001Accuracy of acetabular component alignment with surgical guidance systems during hip arthroplastyXu Joshua0https://orcid.org/0000-0001-7598-6482Veltman Ewout S.1Chai Yuan2Walter William L.3University of SydneyDepartment of Orthopaedic and Trauma Surgery, Royal North Shore HospitalUniversity of SydneyUniversity of SydneyBackground: Navigation in total hip arthroplasty has been shown to improve acetabular positioning and can decrease the incidence of mal-positioned acetabular components. This study aimed to assess two surgical guidance systems by comparing intra-operative measurements of acetabular component inclination and anteversion with a post-operative CT scan. Methods: We prospectively collected intra-operative navigation data from 102 hips receiving conventional THA or hip resurfacing arthroplasty through either a direct anterior or posterior approach. Two guidance systems were used simultaneously: an inertial navigation system (INS) and an optical navigation system (ONS). Acetabular component anteversion and inclination were measured on a post-operative CT. Results: The average age of the patients was 64 years (range: 24–92) and the average BMI was 27 kg/m2 (range 19–38). 52% had hip surgery through an anterior approach. 98% of the INS measurements and 88% of the ONS measurements were within 10° of the CT measurements. The mean (and standard deviation) of the absolute difference between the postoperative CT and the intra-operative measurements for inclination and anteversion were 3.0° (2.8) and 4.5° (3.2) respectively for the ONS, along with 2.1° (2.3) and 2.4° (2.1) respectively for the INS. There was a significantly lower mean absolute difference to CT for the INS when compared to ONS in both anteversions (p < 0.001) and inclination (p = 0.02). Conclusions: We found that both inertial and optical navigation systems allowed for adequate acetabular positioning as measured on postoperative CT, and thus provide reliable intraoperative feedback for optimal acetabular component placement. Level of Evidence: Therapeutic Level II.https://www.sicot-j.org/articles/sicotj/full_html/2023/01/sicotj230001/sicotj230001.htmlnavigationhip arthroplastyoptical navigationinertial navigationacetabular positioning
spellingShingle Xu Joshua
Veltman Ewout S.
Chai Yuan
Walter William L.
Accuracy of acetabular component alignment with surgical guidance systems during hip arthroplasty
SICOT-J
navigation
hip arthroplasty
optical navigation
inertial navigation
acetabular positioning
title Accuracy of acetabular component alignment with surgical guidance systems during hip arthroplasty
title_full Accuracy of acetabular component alignment with surgical guidance systems during hip arthroplasty
title_fullStr Accuracy of acetabular component alignment with surgical guidance systems during hip arthroplasty
title_full_unstemmed Accuracy of acetabular component alignment with surgical guidance systems during hip arthroplasty
title_short Accuracy of acetabular component alignment with surgical guidance systems during hip arthroplasty
title_sort accuracy of acetabular component alignment with surgical guidance systems during hip arthroplasty
topic navigation
hip arthroplasty
optical navigation
inertial navigation
acetabular positioning
url https://www.sicot-j.org/articles/sicotj/full_html/2023/01/sicotj230001/sicotj230001.html
work_keys_str_mv AT xujoshua accuracyofacetabularcomponentalignmentwithsurgicalguidancesystemsduringhiparthroplasty
AT veltmanewouts accuracyofacetabularcomponentalignmentwithsurgicalguidancesystemsduringhiparthroplasty
AT chaiyuan accuracyofacetabularcomponentalignmentwithsurgicalguidancesystemsduringhiparthroplasty
AT walterwilliaml accuracyofacetabularcomponentalignmentwithsurgicalguidancesystemsduringhiparthroplasty