Arthroplasty最新文献

{"title":"Novel subtype of coxitis knee associated with acetabular dysplasia of the hip: a case series.","authors":"Patricio Iii Dumlao, Kiminori Yukata, Yutaka Suetomi, Atsunori Tokushige, Takashi Sakai, Hiroshi Fujii","doi":"10.1186/s42836-023-00225-z","DOIUrl":"10.1186/s42836-023-00225-z","url":null,"abstract":"<p><strong>Background: </strong>Multiple joint arthritis patterns require a comprehensive understanding to optimize patient management. This study aimed to present a patient cohort that deviated from known definitions of coxitis knee (CK), identifying and characterizing this atypical group.</p><p><strong>Methods: </strong>Patients undergoing both total hip arthroplasty and total knee arthroplasty between January 2008 and December 2018 were retrospectively reviewed. The patients were classified into a typical coxitis knee group (classic, long leg arthropathy, and windswept deformity) and an atypical coxitis knee group. Leg-length discrepancy, body mass index (BMI), and radiographic parameters of the groups were compared and analyzed.</p><p><strong>Results: </strong>A total of 31 patients were allocated to the typical coxitis knee group (n = 10), and atypical coxitis knee group (n = 21). In the atypical group, 27 hips were involved, of which 21 had acetabular dysplasia, 5 exhibited subchondral insufficiency fracture-like changes, and only 1 had classic osteoarthritis. Among the 27 knees undergoing total knee arthroplasty, 26 showed varus alignment, 1 was within the normal range, and none was valgus. Acetabular dysplasia involved ipsilateral (n = 1), contralateral (n = 14), and bilateral (n = 6) hips, showing atypical coxitis knee. Patients with acetabular dysplasia were more likely to exhibit atypical CK.</p><p><strong>Conclusion: </strong>Most patients in the cohort displayed acetabular dysplasia and contralateral varus knees, constituting a pattern referred to as acetabular dysplasia-associated gonarthritis. Identifying this novel subtype may have important clinical implications for regions with high risk factors, where acetabular dysplasia and constitutional genu varum are prevalent.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"6 1","pages":"10"},"PeriodicalIF":0.9,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10837952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139673593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding immune-mediated cobalt/chromium allergy to orthopaedic implants: a meta-synthetic review.","authors":"Arnold Chen, Andrew P Kurmis","doi":"10.1186/s42836-023-00227-x","DOIUrl":"10.1186/s42836-023-00227-x","url":null,"abstract":"<p><strong>Background: </strong>The frequency of primary joint replacement surgery continues to increase worldwide. While largely considered biologically inert entities, an increasing body of evidence continues to validate a not insignificant incidence of allergic reactions to such implants. Little previous work has explored genuinely immune-mediated reactivity in this context. In the absence of a contemporary published summary on the topic, this paper explored the current state of understanding of cobalt/chromium allergy and proposes a patient management algorithm whereby such immune reactions are clinically suggested.</p><p><strong>Methods: </strong>A structured, systematic literature review was performed by following PRISMA search principles to provide an updated review of this area.</p><p><strong>Results: </strong>Thirty-six topic-related articles were identified, the majority reflecting lower tiers of scientific evidence with a lack of homogeneous quantitative data to facilitate valid cohort comparisons. Largely, the available literature represented small case series' or expert opinions.</p><p><strong>Conclusions: </strong>Despite increasing clinical awareness and acknowledgement of true allergy to joint replacement components, this review highlighted that the evidence base underpinning the diagnosis and management of such patients is limited. Both patient-reported metal allergy or skin patch testing are grossly unreliable methods and show almost no correlation with true immune reactivity. Recent studies suggested a potential role for patient-specific in vitro cellular activation testing and/or targeted genetic testing when cobalt/chromium allergy is clinically suspected. However, while likely representing the contemporary \"best available\" approaches both can be costly undertakings, are not yet universally available, and still require broader validation in non-research settings before wider uptake can be championed.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"6 1","pages":"1"},"PeriodicalIF":0.9,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10835847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139673594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prospective, randomized trial of liposomal bupivacaine compared to conventional bupivacaine on pain control and postoperative opioid use in adults receiving adductor canal blocks for total knee arthroplasty.","authors":"Aurora Quaye, Brian McAllister, Joseph R Garcia, Orion Nohr, Sarah J Laduzenski, Lucy Mack, Christine R Kerr, Danielle A Kerr, Charonne N Razafindralay, Janelle M Richard, Wendy Y Craig, Stephen Rodrigue","doi":"10.1186/s42836-023-00226-y","DOIUrl":"10.1186/s42836-023-00226-y","url":null,"abstract":"<p><strong>Background: </strong>Total knee arthroplasty (TKA) is a commonly performed procedure to alleviate pain and improve functional limitations caused by end-stage joint damage. Effective management of postoperative pain following TKA is crucial to the prevention of complications and enhancement of recovery. Adductor canal blocks (ACB) with conventional bupivacaine (CB) provide adequate analgesia after TKA, but carry a risk of rebound pain following block resolution. Liposomal bupivacaine (LB) is an extended-release local anesthetic that can provide up to 72 h of pain relief. The objective of this study was to compare postoperative outcomes between ACBs using LB and CB after TKA.</p><p><strong>Methods: </strong>This single institution, prospective, randomized, clinical trial enrolled patients scheduled for TKA. Participants were randomized to receive ACB with either LB or CB. Pain scores up to 72 h postoperatively were assessed as the primary outcome. Opioid consumption and length of stay were evaluated as secondary outcomes.</p><p><strong>Results: </strong>A total of 80 patients were enrolled. Demographic and clinical characteristics were similar between the two groups. LB group showed significantly lower cumulative opioid use during the 72 h evaluated (P = 0.016). There were no differences in pain scores or length of stay between the groups.</p><p><strong>Conclusion: </strong>The study demonstrated that LB ACBs led to significantly lower opioid consumption in the days following TKA without affecting pain scores or length of stay. This finding has important implications for improving postoperative outcomes and reducing opioid use in TKA patients. Previous studies have reported inconsistent results regarding the benefits of LB, highlighting the need for further research.</p><p><strong>Trial registration: </strong>This project was retrospectively registered with clinicaltrials.gov ( NCT05635916 ) on 2 December 2022.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"6 1","pages":"6"},"PeriodicalIF":0.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10832097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leg length discrepancy before total knee arthroplasty is associated with increased complications and earlier time to revision.","authors":"Kevin L Mekkawy, Ty Davis, Philip A Sakalian, Alejandro E Pino, Arturo Corces, Martin W Roche","doi":"10.1186/s42836-023-00221-3","DOIUrl":"10.1186/s42836-023-00221-3","url":null,"abstract":"<p><strong>Introduction: </strong>Leg length discrepancy (LLD) following total knee arthroplasty (TKA) is a common complaint, leading to decreased patient satisfaction. However, the effect of LLD diagnosis prior to TKA on outcomes and complications is not well defined. Thus, this study aimed to assess the effects that LLD has on rates of falls and implant complications, length of stay and readmissions, and implant survivorship following TKA.</p><p><strong>Methods: </strong>A retrospective review of a private insurance claims database was conducted from 2010 to 2021. All cases of TKA and those with a diagnosis of leg length discrepancy were identified. Patients undergoing TKA with a diagnosis of LLD were matched to control patients 1:5 based on demographic and comorbidity profiles. Two-year fall rates and implant complications, lengths of stay, 90-day readmissions, and time to revision were compared between cohorts.</p><p><strong>Results: </strong>A total of 1,378 LLD patients were matched to 6,889 control patients. The LLD group had significantly higher rates of falls, dislocation, mechanical loosening, periprosthetic fracture, and fibrosis when compared to the control group (all P < 0.01). Additionally, mean length of stay was significantly greater in the LLD group (4.9 days vs. 3.0 days, P < 0.001). There was no significant difference in 90-day readmission rates between groups (P = 0.178). Time to revision was significantly shorter in the LLD group (392 days vs. 928 days, P < 0.001).</p><p><strong>Conclusions: </strong>Leg length discrepancy in patients undergoing TKA was associated with significantly increased fall risk, rates of implant complications, length of stay, and faster time to revision. The findings of this study may allow orthopedic surgeons to identify those patients at risk and allow for more educated patient counseling and operative planning.</p><p><strong>Level of evidence: </strong>III, retrospective case-control study.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"6 1","pages":"5"},"PeriodicalIF":0.9,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10790485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139473105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does size matter? Outcomes following revision total hip arthroplasty with long or primary stems: a systematic review and meta-analysis.","authors":"Rajpreet Sahemey, Ali Ridha, Alastair Stephens, Muhamed M Farhan-Alanie, Jakub Kozdryk, Bryan Riemer, Pedro Foguet","doi":"10.1186/s42836-023-00228-w","DOIUrl":"10.1186/s42836-023-00228-w","url":null,"abstract":"<p><strong>Background: </strong>Femoral reconstruction with long stems is widely accepted as the standard in revision total hip arthroplasty (rTHA). However, long stems can be technically challenging to insert and can compromise bone stock for future revision. This study aimed to identify whether there was a difference in outcomes with using a long versus primary or short femoral stem in revision.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis of all articles comparing long and primary stem length in rTHA for Paprosky 1-3B femoral defects. The primary outcome measure was the reoperation rate after rTHA. Secondary outcomes included infection and dislocation rates, periprosthetic fracture, loosening, mortality, and patient-reported outcome measures (PROMs).</p><p><strong>Results: </strong>The results of 3,102 rTHAs performed in 2,982 patients were reported from 9 eligible studies in the systematic review, of which 6 were included in the meta-analysis. The mean patient age was 67.4 and the mean follow-up lasted 5 years (range, 1-15 years). There was no significant difference in the reoperation rate (odds ratio 0.78; 95% confidence interval, 0.28-2.17, P = 0.63). Similarly, there was no significant difference in dislocation or periprosthetic fracture risk. Harris Hip Score was better with primary stems by a mean difference of 14.4 points (P < 0.05). Pooled 5-year stem-related survival was 91.3% ± 3.5% (SD) for primary stems and 89.9% ± 6.7% (SD) for long stems.</p><p><strong>Conclusions: </strong>A primary stem provided non-inferior outcomes compared with long stems in rTHA with Paprosky type 1-3B femoral defects. Primary stems may yield a more straightforward technique and preserve distal bone stock for future revision particularly in younger patients. In older patients with lower functional demands and who would benefit from a decreased risk of complications, a long cemented stem is recommended.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"6 1","pages":"4"},"PeriodicalIF":0.9,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10775576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139405202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imageless navigation system (Naviswiss) provides accurate component position in total hip arthroplasty with lateral decubitus position for end-stage hip osteoarthritis: a prospective cohort study with CT-validation.","authors":"Corey J Scholes, Manaal Fatima, Tobias Schwagli, David Liu","doi":"10.1186/s42836-023-00224-0","DOIUrl":"https://doi.org/10.1186/s42836-023-00224-0","url":null,"abstract":"<p><strong>Aims: </strong>The Naviswiss system (Naviswiss AG, Brugg, Switzerland) is a handheld imageless navigation device used to improve the accuracy of implant positioning in total hip arthroplasty (THA). However, clinical data for leg length discrepancy and femoral offset is lacking, and the validity of the system has not been reported for patients undergoing THA in the lateral decubitus position. This study aimed to report the accuracy of the device in this patient population.</p><p><strong>Methods: </strong>Patients underwent THA in the lateral decubitus position performed by a single surgeon. Component position measured by the device intraoperatively was compared to postoperative measurements on computed tomography (CT) scans. Agreement between the navigation system and postoperative measurements was reported for acetabular cup inclination, acetabular cup version, femoral offset, and leg length discrepancy.</p><p><strong>Results: </strong>Thirty-three patients were included in the analysis. The mean difference between intraoperative and postoperative CT measurements was within 2° for angular measurements and 2 mm for leg length. Absolute differences in the two indices were up to 4° and 3 mm. The mean bias was 1°-2° overestimation for cup orientation and up to 2 mm overestimation for leg length change. However, 95% limits of agreement did not exceed absolute thresholds of 10° and 10 mm, especially after correction for bias. One case (3%) was declared intraoperatively for issues with fixation on the greater trochanter.</p><p><strong>Conclusions: </strong>The accuracy of the Naviswiss system falls within clinically acceptable recommendations for acetabular cup placement, femoral offset, and leg length for total hip arthroplasty with a anterolateral approach in lateral decubitus position. The system could be further improved with regression-based bias correction.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"6 1","pages":"3"},"PeriodicalIF":0.9,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10773062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139405203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional somatic syndromes are associated with inferior outcomes and increased complications after hip and knee arthroplasty: a systematic review.","authors":"Raisa Masood, Krishna Mandalia, Nicholas R Pagani, Michael A Moverman, Richard N Puzzitiello, Mariano E Menendez, Matthew J Salzler","doi":"10.1186/s42836-023-00223-1","DOIUrl":"10.1186/s42836-023-00223-1","url":null,"abstract":"<p><strong>Background: </strong>Functional somatic syndromes (FSSs), defined as chronic physical symptoms with no identifiable organic cause, may impact results after hip and knee arthroplasty. The purpose of this study was to perform a systematic review assessing the relationship between FSSs and clinical outcomes after primary total hip arthroplasty (THA), total knee arthroplasty (TKA), and unicompartmental knee arthroplasty (UKA).</p><p><strong>Methods: </strong>The PubMed and Web of Science databases were queried from January 1955 through December 2021 for studies investigating the impact of at least one FSS (fibromyalgia, irritable bowel syndrome (IBS), chronic headaches, and chronic low back pain) on outcomes after primary THA/TKA/UKA. Outcomes of interest included patient-reported outcome measures (PROMs), postoperative opioid use, complications, revisions, and costs of care.</p><p><strong>Results: </strong>There were twenty-eight studies, including 768,909 patients, of which 378,384 had an FSS. Five studies reported preoperative PROMs prior to THA/TKA, all of which showed worse PROMs among patients with at least 1 FSS diagnosis. Thirteen studies reported postoperative PROMs after THA/TKA, all of which demonstrated worse PROMs among patients with at least 1 FSS diagnosis. Patients with FSS diagnoses were more likely to continue using opioids at 3, 6, and 12 months following TKA, THA, and UKA. Medical and surgical complications, as well as revision rates, were higher among patients with FSSs.</p><p><strong>Conclusion: </strong>Patients with FSSs have inferior PROMs and are at increased risk for prolonged postoperative opioid use, medical and surgical complications, and revision after hip and knee arthroplasty. Improved understanding of the factors influencing the success of hip and knee arthroplasty is critical. Future studies should address the biopsychosocial determinants of health that can impact outcomes after total joint arthroplasty.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"6 1","pages":"2"},"PeriodicalIF":0.9,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10765755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139089305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital orthopedics in the new AI era: from ASIA aspect.","authors":"Yan Wang","doi":"10.1186/s42836-023-00220-4","DOIUrl":"https://doi.org/10.1186/s42836-023-00220-4","url":null,"abstract":"<p><p>This editorial explores the transformative impact of artificial intelligence (AI) on orthopedics, with a particular focus on advancements in Asia. It delves into the integration of AI in hospitals, advanced applications in China, and future expectations. The discussion is underpinned by an examination of AI's role in assisted diagnosis, treatment planning, surgical navigation, predictive analysis, and post-operative rehabilitation monitoring.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"5 1","pages":"61"},"PeriodicalIF":0.9,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10717913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138813055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: factors influencing the outcome of total hip and knee arthroplasty.","authors":"Nicholas D Clement, Chloe E H Scott","doi":"10.1186/s42836-023-00219-x","DOIUrl":"10.1186/s42836-023-00219-x","url":null,"abstract":"<p><strong>Background: </strong>Total hip and knee arthroplasty for end stage arthritis are among the most cost-effective interventions available in all of medicine. Success of hip and knee arthroplasties is not universal and approximately one in ten patients are not satisfied with their arthroplasty and 10 to 34% of patients have an unfavourable long term pain outcome. The aim of this edition of Arthroplasty was to identify factors associated with: (1) poor joint specific outcome, (2) poor health related quality of life outcome and (3) dissatisfaction following total hip and knee arthroplasty.</p><p><strong>Methods: </strong>The scope was deliberately broad to identify factors (known and unknown) that influence outcome of total hip and knee arthroplasty, and of 40 submissions, eight were selected for this special edition after peer review.</p><p><strong>Results: </strong>Many of the included studies reported subjective patient reported outcome measures as their key outcomes but other objective measures such as muscle mass, timed Up-and-Go test, kneeling ability and postoperative pain are also featured. Some studies involved a focus on early rehabilitation after surgery (ERAS) principles and how to optimise pre-rehabilitation and reduce length of hospital stay readmission and reoperation. The effect of metal allergy and drain usage on outcomes is also explored. A variety of methodologies have been used including one randomised control trial, some machine learning and three systematic reviews investigating the effect of metal allergy on outcomes, associations with postoperative pain and the effect of patella resurfacing.</p><p><strong>Conclusion: </strong>This special edition has advanced our knowledge of factors influencing to the outcome of hip and knee arthroplasty but has also identified several areas of research that need to be addressed to improve the outcomes of our patients.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"5 1","pages":"64"},"PeriodicalIF":0.9,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10698944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138489097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT validation of intraoperative imageless navigation (Naviswiss) for component positioning accuracy in primary total hip arthroplasty in supine patient position: a prospective observational cohort study in a single-surgeon practice.","authors":"Corey Scholes, Tobias Schwagli, John Ireland","doi":"10.1186/s42836-023-00217-z","DOIUrl":"10.1186/s42836-023-00217-z","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to report on the validity of the Naviswiss handheld image-free navigation device for accurate intraoperative measurement of THA component positioning, in comparison with the three-dimensional (3D) reconstruction of computed tomography (CT) images as the gold standard.</p><p><strong>Methods: </strong>A series of patients presenting to a single-surgeon clinic with end-stage hip osteoarthritis received primary hip arthroplasty with the anterolateral muscle-sparing surgical approach in the supine position. Imageless navigation was applied during the procedure with bone-mounted trackers applied to the greater trochanter and ASIS. Patients underwent routine CT scans before and after surgery and these were analyzed by using three-dimensional reconstruction to generate cup orientation, offset and leg length changes, which were compared to the intraoperative measurements provided by the navigation system. Estimates of agreement between the intraoperative and image-derived measurements were assessed with and without correction for bias and declared cases with potential measurement issues.</p><p><strong>Results: </strong>The mean difference between intraoperative and postoperative CT measurements was within 2° for angular measurements and 2 mm for leg length. Absolute differences for the two indices were between 5° and 4 mm. Mean bias was 1.9°-3.6° underestimation for cup orientation and up to 2 mm overestimation for leg length change, but absolute thresholds of 10° and 10 mm were not exceeded by 95% limits of agreement (LOA), especially after correction for bias. Four cases (12%) were declared intraoperatively for issues with fixation on the greater trochanter. Inclusion of these cases generated acceptable accuracy overall and their omission failed to improve between-case variability in accuracy or LOA for both offset and leg length.</p><p><strong>Conclusions: </strong>The accuracy of the Naviswiss system applied during primary THA in a supine position and anterolateral surgical approach falls within clinically acceptable recommendations for acetabular cup placement, femoral offset, and length. With refinements to surgical technique to adapt to the navigation hardware, the system could be further improved with regression-based bias correction.</p><p><strong>Trial registration: </strong>Registered with the Australian New Zealand Clinical Trials Registry (ACTRN12618000317291).</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"5 1","pages":"63"},"PeriodicalIF":2.3,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10696686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138483420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}