Eric M. Slotkin DO , Francesca Coxe MD , Tristan Jones BaSC, MPT, MBA , Thomas Morton PA-C , Stefan Kreutzer MD , Allejandro Della-Valle MD
{"title":"基于图像的手持便携式系统在提供准确的髋臼组件定位方面可能优于计算机导航或机器人平台","authors":"Eric M. Slotkin DO , Francesca Coxe MD , Tristan Jones BaSC, MPT, MBA , Thomas Morton PA-C , Stefan Kreutzer MD , Allejandro Della-Valle MD","doi":"10.1016/j.artd.2024.101511","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Malposition of the acetabular component during total hip arthroplasty (THA) is a leading cause of complications and need for revision. Robotic-assisted THA purports to improve accuracy of component positioning with many reports demonstrating over 92% of components within 10° of inclination and anteversion compared to intraoperative system output. This study aimed to evaluate the intraoperative accuracy output of acetabular cup position values using a handheld miniaturized portable navigation system (Naviswiss, AG) compared to postoperative computed tomography (CT) scans.</div></div><div><h3>Methods</h3><div>A total of 108 direct anterior approach THA surgeries using the intraoperative navigation device were performed over a 6-month period. Intraoperative device output for measured acetabular component inclination and anteversion were recorded and compared with values derived from postoperative CT scans.</div></div><div><h3>Results</h3><div>Postoperative CT analysis of acetabular component positioning demonstrated 97.22% and 94.44% were within 5° of intraoperative inclination and anteversion, respectively, compared to intraoperative values from the navigation unit. No CT demonstrated an absolute inclination or anteversion measurement difference more than 8° from the intraoperative navigation unit value. Overall, 92.59% of components were within 5° and 100% were within 8° for both inclination and anteversion compared to postoperative CT measurements.</div></div><div><h3>Conclusions</h3><div>This handheld portable navigation system yielded highly accurate intraoperative component positioning values confirmed by postoperative CT scans during direct anterior THA, possibly superior to reported robotic-assisted THA values. These smaller, portable, and more accessible intraoperative units may provide surgeons improved accuracy and availability in a number of surgical settings for use in THA.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A Handheld, Portable Image-Based System May Outperform Computer Navigation or Robotic Platforms in Providing Accurate Acetabular Component Positioning\",\"authors\":\"Eric M. Slotkin DO , Francesca Coxe MD , Tristan Jones BaSC, MPT, MBA , Thomas Morton PA-C , Stefan Kreutzer MD , Allejandro Della-Valle MD\",\"doi\":\"10.1016/j.artd.2024.101511\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Malposition of the acetabular component during total hip arthroplasty (THA) is a leading cause of complications and need for revision. Robotic-assisted THA purports to improve accuracy of component positioning with many reports demonstrating over 92% of components within 10° of inclination and anteversion compared to intraoperative system output. This study aimed to evaluate the intraoperative accuracy output of acetabular cup position values using a handheld miniaturized portable navigation system (Naviswiss, AG) compared to postoperative computed tomography (CT) scans.</div></div><div><h3>Methods</h3><div>A total of 108 direct anterior approach THA surgeries using the intraoperative navigation device were performed over a 6-month period. Intraoperative device output for measured acetabular component inclination and anteversion were recorded and compared with values derived from postoperative CT scans.</div></div><div><h3>Results</h3><div>Postoperative CT analysis of acetabular component positioning demonstrated 97.22% and 94.44% were within 5° of intraoperative inclination and anteversion, respectively, compared to intraoperative values from the navigation unit. No CT demonstrated an absolute inclination or anteversion measurement difference more than 8° from the intraoperative navigation unit value. Overall, 92.59% of components were within 5° and 100% were within 8° for both inclination and anteversion compared to postoperative CT measurements.</div></div><div><h3>Conclusions</h3><div>This handheld portable navigation system yielded highly accurate intraoperative component positioning values confirmed by postoperative CT scans during direct anterior THA, possibly superior to reported robotic-assisted THA values. These smaller, portable, and more accessible intraoperative units may provide surgeons improved accuracy and availability in a number of surgical settings for use in THA.</div></div>\",\"PeriodicalId\":37940,\"journal\":{\"name\":\"Arthroplasty Today\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-10-11\",\"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/S2352344124001961\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroplasty Today","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2352344124001961","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
A Handheld, Portable Image-Based System May Outperform Computer Navigation or Robotic Platforms in Providing Accurate Acetabular Component Positioning
Background
Malposition of the acetabular component during total hip arthroplasty (THA) is a leading cause of complications and need for revision. Robotic-assisted THA purports to improve accuracy of component positioning with many reports demonstrating over 92% of components within 10° of inclination and anteversion compared to intraoperative system output. This study aimed to evaluate the intraoperative accuracy output of acetabular cup position values using a handheld miniaturized portable navigation system (Naviswiss, AG) compared to postoperative computed tomography (CT) scans.
Methods
A total of 108 direct anterior approach THA surgeries using the intraoperative navigation device were performed over a 6-month period. Intraoperative device output for measured acetabular component inclination and anteversion were recorded and compared with values derived from postoperative CT scans.
Results
Postoperative CT analysis of acetabular component positioning demonstrated 97.22% and 94.44% were within 5° of intraoperative inclination and anteversion, respectively, compared to intraoperative values from the navigation unit. No CT demonstrated an absolute inclination or anteversion measurement difference more than 8° from the intraoperative navigation unit value. Overall, 92.59% of components were within 5° and 100% were within 8° for both inclination and anteversion compared to postoperative CT measurements.
Conclusions
This handheld portable navigation system yielded highly accurate intraoperative component positioning values confirmed by postoperative CT scans during direct anterior THA, possibly superior to reported robotic-assisted THA values. These smaller, portable, and more accessible intraoperative units may provide surgeons improved accuracy and availability in a number of surgical settings for use in THA.
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.