How Much Does a Computed Tomography-Based Mixed-Reality Navigation System Change Freehand Acetabular Component Position?

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today Pub Date : 2025-03-14 DOI:10.1016/j.artd.2025.101661

Justin Leal BS , Alexander F. Heimann MD , Eric S. Dilbone MD , Sean P. Ryan MD , Samuel S. Wellman MD

{"title":"How Much Does a Computed Tomography-Based Mixed-Reality Navigation System Change Freehand Acetabular Component Position?","authors":"Justin Leal BS , Alexander F. Heimann MD , Eric S. Dilbone MD , Sean P. Ryan MD , Samuel S. Wellman MD","doi":"10.1016/j.artd.2025.101661","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>This study evaluates how a computed tomography-based mixed-reality (MR) navigation system impacts acetabular component orientation compared to freehand positioning in total hip arthroplasty.</div></div><div><h3>Methods</h3><div>A series of 79 patients who underwent total hip arthroplasty utilizing a computed tomography-based MR navigation system were reviewed. The surgeon initially placed the acetabular cup freehand, attempting to achieve the preoperative plan, and this initial intraoperative orientation was recorded. The cup was then adjusted to the planned position. The difference between freehand and planned tilt-adjusted operative anteversion (OA) and inclination (OI) determined the navigation tool’s impact.</div></div><div><h3>Results</h3><div>The mean preoperative planned OA was 30.1 ± 2.0 (range: 25, 35) degrees, and the mean freehand intraoperative OA was 30.2 ± 9.1 (range: 4, 57) degrees (<em>P</em> = .885), requiring a mean adjustment of 6.8 ± 5.1 (range: 0, 23) degrees. Freehand OA was corrected at least 5 degrees in 54.4% (43/79) of cases. The mean preoperative planned OI was 40.8 ± 0.6 (range: 39, 42) degrees, and the mean freehand intraoperative OI was 37.8 ± 6.6 (range: 18, 53) degrees (<em>P</em> < .001), requiring a mean adjustment of 5.7 ± 4.5 (range: 0, 22) degrees to achieve. Freehand OI was corrected at least 5 degrees in 43.0% (34/79) of cases.</div></div><div><h3>Conclusions</h3><div>Freehand acetabular component positioning in the lateral position is variable when attempting to execute patient-specific numerical cup orientation targets. Use of this navigation tool led the surgeon to correct more than 5 degrees in both OA and OI in roughly half of the hips.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"32 ","pages":"Article 101661"},"PeriodicalIF":1.5000,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroplasty Today","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2352344125000482","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background

This study evaluates how a computed tomography-based mixed-reality (MR) navigation system impacts acetabular component orientation compared to freehand positioning in total hip arthroplasty.

Methods

A series of 79 patients who underwent total hip arthroplasty utilizing a computed tomography-based MR navigation system were reviewed. The surgeon initially placed the acetabular cup freehand, attempting to achieve the preoperative plan, and this initial intraoperative orientation was recorded. The cup was then adjusted to the planned position. The difference between freehand and planned tilt-adjusted operative anteversion (OA) and inclination (OI) determined the navigation tool’s impact.

Results

The mean preoperative planned OA was 30.1 ± 2.0 (range: 25, 35) degrees, and the mean freehand intraoperative OA was 30.2 ± 9.1 (range: 4, 57) degrees (P = .885), requiring a mean adjustment of 6.8 ± 5.1 (range: 0, 23) degrees. Freehand OA was corrected at least 5 degrees in 54.4% (43/79) of cases. The mean preoperative planned OI was 40.8 ± 0.6 (range: 39, 42) degrees, and the mean freehand intraoperative OI was 37.8 ± 6.6 (range: 18, 53) degrees (P < .001), requiring a mean adjustment of 5.7 ± 4.5 (range: 0, 22) degrees to achieve. Freehand OI was corrected at least 5 degrees in 43.0% (34/79) of cases.

Conclusions

Freehand acetabular component positioning in the lateral position is variable when attempting to execute patient-specific numerical cup orientation targets. Use of this navigation tool led the surgeon to correct more than 5 degrees in both OA and OI in roughly half of the hips.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Arthroplasty Today Medicine-Surgery

CiteScore

2.90

自引率

0.00%

发文量

258

审稿时长

40 weeks

期刊介绍： Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.