TITLE

Improving Cup Positioning Using a Mechanical Navigation Instrument

AUTHOR(S)
Steppacher, Simon D.; Kowal, Jens H.; Murphy, Stephen Barry
PUB. DATE
February 2011
SOURCE
Clinical Orthopaedics & Related Research;Feb2011, Vol. 469 Issue 2, p423
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Although surgical navigation reduces the rate of malpositioned acetabular cups in total hip arthroplasty (THA), its use has not been widely adopted. As a result of our perceived need for simple and efficient methods of navigation, we developed a mechanical navigation device for acetabular cup orientation. Questions/purposes: We assessed accuracy of cup orientation (mean error of cup inclination and anteversion) of a novel mechanical navigation device, percentage of outliers, length of operation, and compared the results with a series of CT-based computer-assisted THAs. Methods: Cup orientation of 70 THAs performed using the mechanical navigation device was compared with a historical control group of 146 THAs performed using CT-based computer navigation. Postoperative cup orientation was measured using a validated two-dimensional/three-dimensional matching method. An outlier was defined outside a range of ± 10° from the planned inclination and/or anteversion. Results: Using the mechanical navigation device, we observed a decrease in the errors of inclination (1.3° ± 3.4° [range, −6.6° to 8.2°] versus 3.5° ± 4.2° [−12.7° to 6.9°]), errors of anteversion (1.0° ± 4.1° [−8.8° to 9.5°] versus 3.0° ± 5.8° [−11.8° to 19.6°]), percentages of outliers (0% versus 9.6%), and length of operation (112 ± 22 [78-184] minutes versus 132 ± 18 [90-197] minutes) compared with CT-based navigation. Conclusions: Compared with CT-based surgical navigation, navigation of acetabular cup orientation using a mechanical device can be performed in less time, lower mean errors, and minimal equipment.
ACCESSION #
57241198

 

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