Augmented reality navigation systems vs. conventional techniques in acetabular cup positioning: a systematic review and meta-analysis

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-07-08 DOI:10.1016/j.jor.2025.07.005

Dimitrios Mouselimis , Xanthippi Topalidou , Konstantinos Papadopoulos , Martin Brucker , Gábor Molnár , André R. Zahedi , Christian Lüring

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引用次数: 0

Abstract

Purpose

The aim of this systematic review and meta-analysis was to evaluate the effectiveness of augmented reality (AR) techniques in acetabular cup positioning during total hip arthroplasty (THA).

Methods

The Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE databases were systematically searched until December 12, 2024 according to the PRISMA 2020 guidelines for prospective and retrospective studies comparing AR techniques to conventional ones regarding acetabular cup positioning. Anteversion, inclination angles, blood loss, operation time and postoperative complications comprised the outcomes. Bias assessment was performed with the RoB 2 tool for prospective studies and ROBINS-I for retrospective ones.

Results

In total, 9 studies were included in the systematic review and 8 in the meta-analysis. The target error according to postoperative radiographs or computer scan for both anteversion and inclination angles was significantly more precise in the 346 THAs of the AR group (Z_inclination = 3.10, P_inclination = 0.002, Std. mean difference = −0.52 [95 % CI: 0.85 to −0.19] and Z_anteversion = 2.44, P_anteversion = 0.01, Std. mean difference = −0.57 [95 % CI: 1.03 to −0.11]) with a significant substantial heterogeneity (I²_inclination = 79 %, P_inclination<0.0001 and I²_anteversion = 89 %, P_anteversion < 0.00001), when compared to the 395 THAs of the conventional group. Regarding blood loss, operation time and postoperative complications, no significant differences were observed. The risk of bias was high among the retrospective studies.

Conclusion

The different types of studies, as well as their individual way of assessing the acetabular cup angles are the main limitations of the meta-analysis. The results provide a strong sign of improved acetabular cup positioning with the help of AR systems, while maintaining a favorable safety profile.

Prospero registration number

CRD42024609350.

查看原文本刊更多论文

增强现实导航系统与传统技术在髋臼杯定位：系统回顾和荟萃分析

目的本系统综述和荟萃分析的目的是评估增强现实（AR）技术在全髋关节置换术（THA）中髋臼杯定位的有效性。方法根据PRISMA 2020指南，系统检索Cochrane中央对照试验注册库、MEDLINE和EMBASE数据库，以比较AR技术与传统技术在髋臼杯定位方面的前瞻性和回顾性研究，直至2024年12月12日。手术前倾、倾斜角度、出血量、手术时间和术后并发症构成手术结果。前瞻性研究使用rob2工具，回顾性研究使用ROBINS-I工具进行偏倚评估。结果系统评价共纳入9项研究，meta分析纳入8项研究。根据术后x线片或计算机扫描的目标误差，AR组346例tha (z倾角= 3.10，p倾角= 0.002，平均差值= - 0.52 [95% CI: 0.85 ~ - 0.19]，前倾= 2.44，前倾= 0.01，平均差值= - 0.57 [95% CI：1.03 ~−0.11])，具有显著的异质性(i2倾角= 79%，p倾角<；0.0001， i2前倾= 89%,Panteversion <；0.00001)，与常规组的395个tha相比。出血量、手术时间、术后并发症无显著差异。回顾性研究的偏倚风险较高。结论不同类型的研究以及各自评估髋臼杯角的方法是meta分析的主要局限性。结果表明，在增强现实系统的帮助下，髋臼杯定位得到了改善，同时保持了良好的安全性。普洛斯彼罗注册号crd42024609350。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.