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

IF 1.8 Q2 ORTHOPEDICS
SICOT-J Pub Date : 2023-01-01 DOI:10.1051/sicotj/2023010
Joshua Xu, Ewout S Veltman, Yuan Chai, William L Walter
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引用次数: 0

Abstract

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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髋关节置换术中手术引导系统对髋臼假体定位的准确性。
背景:全髋关节置换术中导航已被证明可以改善髋臼定位,并可以减少髋臼假体定位错误的发生率。本研究旨在通过比较术中髋臼成分倾斜和前倾的测量与术后CT扫描来评估两种手术指导系统。方法:我们前瞻性地收集了102例髋关节的术中导航数据,这些髋关节通过直接前路或后路接受了常规THA或髋关节置换术。同时使用两种制导系统:惯性导航系统(INS)和光学导航系统(ONS)。术后CT测量髋臼前倾和倾斜。结果:患者平均年龄64岁(范围24 ~ 92岁),平均BMI为27 kg/m2(范围19 ~ 38)。52%的患者接受了髋关节前路手术。98%的INS测量值和88%的ONS测量值与CT测量值的误差在10°以内。术后CT与术中倾斜度和前倾测量值绝对差值的平均值(和标准差)ONS分别为3.0°(2.8)和4.5°(3.2),INS分别为2.1°(2.3)和2.4°(2.1)。与ONS相比,INS在两种前倾情况下与CT的平均绝对差值明显更低(p结论:我们发现惯性和光学导航系统都可以在术后CT上测量髋臼定位,从而为最佳髋臼组件放置提供可靠的术中反馈。证据等级:治疗性II级。
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来源期刊
SICOT-J
SICOT-J ORTHOPEDICS-
CiteScore
3.20
自引率
12.50%
发文量
44
审稿时长
14 weeks
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