nach oben

Archives of Orthopaedic and Trauma Surgery

Erschienen in:

25.04.2024 | Hip Arthroplasty

Accuracy of portable navigation during THA in patients with severe developmental dysplasia of hip

verfasst von: Shinya Hayashi, Yuichi Kuroda, Naoki Nakano, Tomoyuki Matsumoto, Tomoyuki Kamenaga, Masanori Tsubosaka, Ryosuke Kuroda

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 5/2024

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Correct cup placement in total hip arthroplasty (THA) for patients with developmental dysplasia of the hip (DDH) is considerably difficult. This study aimed to analyze the orientation accuracy of cup insertion during THA using a portable navigation system in patients with DDH.

Materials and methods

In this retrospective cohort study, we analyzed data from 64 patients who underwent THA using infrared stereo camera-matching portable navigation. Patients underwent THA via the anterolateral approach in the lateral decubitus position. Navigation records for intraoperative cup angles, postoperative cup angles measured on computed tomography (CT) images, and cup angle measurement differences were measured and compared between patients with non-DDH/mild DDH and severe DDH. Furthermore, the predictive factors for outliers of accurate acetabular cup placement were analyzed.

Results

The average measurement absolute abduction differences (postoperative CT-navigation record) were 3.9 ± 3.5° (severe DDH) and 3.3 ± 2.6° (non-DDH/ mild DDH), and the anteversion differences were 4.7 ± 3.4° (severe DDH) and 2.3 ± 2.1° (non-DDH/ mild DDH). The anteversion difference was different between the two groups. Multivariate analysis showed that the navigation difference (absolute difference in anteversion between postoperative CT and navigation records of > 5°) was significantly associated with severe DDH (odds ratio [OR]: 3.3; p = 0.049, 95% confidence interval [CI]: 1.0–11.1) and posterior pelvic tilt (OR: 1.1; p = 0.042, 95% CI: 1.0–1.27).

Conclusions

In patients with severe DDH, it is important to pay close attention during THA using portable navigation. However, the average difference was < 5º even in patients with severe DDH, and the accuracy may be acceptable in a clinical setting when the cost is considered.

Hedlundh U, Fredin H (1995) Patient characteristics in dislocations after primary total hip arthroplasty. 60 patients compared with a control group. Acta Orthop Scand 66(3):225CrossRefPubMed

Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR (1978) Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am 60(2):217CrossRefPubMed

Kennedy JG, Rogers WB, Soffe KE, Sullivan RJ, Griffen DG, Sheehan LJ (1998) Effect of acetabular component orientation on recurrent dislocation, pelvic osteolysis, polyethylene wear, and component migration. J Arthroplasty 13(5):530CrossRefPubMed

Crowe JF, Mani VJ, Ranawat CS (1979) Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am 61(1):15CrossRefPubMed

Numair J, Joshi AB, Murphy JC, Porter ML, Hardinge K (1997) Total hip arthroplasty for congenital dysplasia or dislocation of the hip. Survivorship analysis and long-term results. J Bone Joint Surg Am 79(9):1352CrossRefPubMed

Chougle A, Hemmady MV, Hodgkinson JP (2005) Severity of hip dysplasia and loosening of the socket in cemented total hip replacement. A long-term follow-up. J Bone Joint Surg Br 87(1):16CrossRefPubMed

Stans AA, Pagnano MW, Shaughnessy WJ, Hanssen AD (1998) Results of total hip arthroplasty for Crowe Type III developmental hip dysplasia. Clin Orthop Relat Res 348:149CrossRef

Rogers BA, Garbedian S, Kuchinad RA, Backstein D, Safir O, Gross AE (2012) Total hip arthroplasty for adult hip dysplasia. J Bone Joint Surg Am 94(19):1809CrossRefPubMed

Wang C, Xiao H, Yang W, Wang L, Hu Y, Liu H, Zhong D (2019) Accuracy and practicability of a patient-specific guide using acetabular superolateral rim during THA in Crowe II/III DDH patients: a retrospective study. J Orthop Surg Res 14(1):19CrossRefPubMedPubMedCentral

10.

Ueoka K, Kabata T, Kajino Y, Yoshitani J, Ueno T, Tsuchiya H (2019) The Accuracy of the computed tomography-based Navigation System in total hip arthroplasty is comparable with Crowe Type IV and Crowe Type I Dysplasia: a case-control study. J Arthroplasty 34(11):2686CrossRefPubMed

11.

Yamada K, Endo H, Tetsunaga T, Miyake T, Sanki T, Ozaki T (2018) Accuracy of Cup Positioning with the computed tomography-based two-dimensional to three-Dimensional Matched Navigation System: a prospective, randomized controlled study. J Arthroplasty 33(1):136CrossRefPubMed

12.

Kajino Y, Kabata T, Maeda T, Iwai S, Kuroda K, Tsuchiya H (2012) Does degree of the pelvic deformity affect the accuracy of computed tomography-based hip navigation? J Arthroplasty 27(9):1651CrossRefPubMed

13.

Hayashi S, Hashimoto S, Kuroda Y, Nakano N, Matsumoto T, Ishida K, Shibanuma N, Kuroda R (2021) Robotic-arm assisted THA can achieve precise cup positioning in developmental dysplasia of the hip: a case control study. Bone Joint Res 10(10):629CrossRefPubMedPubMedCentral

14.

Asai H, Takegami Y, Seki T, Ishiguro N (2021) Pelvic tilt reduces the Accuracy of Acetabular Component Placement when using a portable Navigation System: an in Vitro Study. Arthroplast Today 7:177CrossRefPubMedPubMedCentral

15.

Hayashi S, Hashimoto S, Takayama K, Matsumoto T, Kamenaga T, Fujishiro T, Hiranaka T, Niikura T, Kuroda R (2020) Evaluation of the accuracy of acetabular cup orientation using the accelerometer-based portable navigation system. J Orthop Sci 25(4):612CrossRefPubMed

16.

Tsukada S, Ogawa H, Hirasawa N, Nishino M, Aoyama H, Kurosaka K (2022) Augmented reality- vs accelerometer-based portable Navigation System to improve the Accuracy of Acetabular Cup Placement during Total Hip Arthroplasty in the lateral decubitus position. J Arthroplasty 37(3):488CrossRefPubMed

17.

Bradley MP, Benson JR, Muir JM (2019) Accuracy of Acetabular Component Positioning using computer-assisted Navigation in Direct Anterior Total Hip Arthroplasty. Cureus 11(4):e4478PubMedPubMedCentral

18.

Kamenaga T, Hayashi S, Hashimoto S, Matsumoto T, Takayama K, Fujishiro T, Hiranaka T, Niikura T, Kuroda R (2019) Accuracy of cup orientation and learning curve of the accelerometer-based portable navigation system for total hip arthroplasty in the supine position. J Orthop Surg (Hong Kong) 27(2):2309499019848871CrossRefPubMed

19.

Widmer KH, Zurfluh B (2004) Compliant positioning of total hip components for optimal range of motion. J Orthop Res 22(4):815CrossRefPubMed

20.

Redmond JM, Gupta A, Hammarstedt JE, Petrakos A, Stake CE, Domb BG (2016) Accuracy of Component Placement in robotic-assisted total hip arthroplasty. Orthopedics 39(3):193CrossRefPubMed

21.

Kanawade V, Dorr LD, Banks SA, Zhang Z, Wan Z (2015) Precision of robotic guided instrumentation for acetabular component positioning. J Arthroplasty 30(3):392CrossRefPubMed

22.

Tanino H, Nishida Y, Mitsutake R, Ito H (2020) Portable accelerometer-based Navigation System for Cup Placement of total hip arthroplasty: a prospective, randomized, controlled study. J Arthroplasty 35(1):172CrossRefPubMed

23.

Cross MB, Schwarzkopf R, Miller TT, Bogner EA, Muir JM, Vigdorchik JM (2018) Improving registration accuracy during total hip arthroplasty: a cadaver study of a new, 3-D mini-optical navigation system. Hip Int 28(1):33CrossRefPubMed

24.

Iwakiri K, Kobayashi A, Ohta Y, Minoda Y, Takaoka K, Nakamura H (2017) Efficacy of a pelvic lateral positioner with a Mechanical Cup Navigator based on the anatomical pelvic plane in total hip arthroplasty. J Arthroplasty 32(12):3659CrossRefPubMed

25.

DiGioia AM, Jaramaz B, Blackwell M, Simon DA, Morgan F, Moody JE, Nikou C, Colgan BD, Aston CA, Labarca RS, Kischell E, Kanade T (1998) The Otto Aufranc Award. Image guided navigation system to measure intraoperatively acetabular implant alignment. Clin Orthop Relat Res (355): 8

26.

Tsutsui T, Goto T, Wada K, Takasago T, Hamada D, Sairyo K (2017) Efficacy of a computed tomography-based navigation system for placement of the acetabular component in total hip arthroplasty for developmental dysplasia of the hip. J Orthop Surg (Hong Kong) 25(3):2309499017727954CrossRefPubMed

27.

Jingushi S, Mizu-uchi H, Nakashima Y, Yamamoto T, Mawatari T, Iwamoto Y (2007) Computed tomography-based navigation to determine the socket location in total hip arthroplasty of an osteoarthritis hip with a large leg length discrepancy due to severe acetabular dysplasia. J Arthroplasty 22(7):1074CrossRefPubMed

28.

Buckland AJ, Vigdorchik J, Schwab FJ, Errico TJ, Lafage R, Ames C, Bess S, Smith J, Mundis GM, Lafage V (2015) Acetabular Anteversion Changes due to spinal deformity correction: bridging the gap between hip and spine surgeons. J Bone Joint Surg Am 97(23):1913CrossRefPubMed

29.

Hasegawa M, Naito Y, Tone S, Wakabayashi H, Sudo A (2020) Accuracy of acetabular cup insertion in an anterolateral supine approach using an accelerometer-based portable navigation system. J Artif Organs

30.

Kamenaga T, Hayashi S, Hashimoto S, Takayama K, Fujishiro T, Hiranaka T, Kuroda R, Matsumoto T (2020) Intraoperative pelvic movement is associated with the body mass index in patients undergoing total hip arthroplasty in the supine position. J Orthop Sci 25(3):446CrossRefPubMed

Titel: Accuracy of portable navigation during THA in patients with severe developmental dysplasia of hip
verfasst von: Shinya Hayashi
Yuichi Kuroda
Naoki Nakano
Tomoyuki Matsumoto
Tomoyuki Kamenaga
Masanori Tsubosaka
Ryosuke Kuroda
Publikationsdatum: 25.04.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Orthopaedic and Trauma Surgery / Ausgabe 5/2024
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-024-05338-x

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Knie-TEP: Kein Vorteil durch antibiotikahaltigen Knochenzement

29.05.2024 Periprothetische Infektionen Nachrichten

Zur Zementierung einer Knie-TEP wird in Deutschland zu über 98% Knochenzement verwendet, der mit einem Antibiotikum beladen ist. Ob er wirklich besser ist als Zement ohne Antibiotikum, kann laut Registerdaten bezweifelt werden.

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

28.05.2024 Häusliche Gewalt Nachrichten

In der Notaufnahme wird die Chance, Opfer von häuslicher Gewalt zu identifizieren, von Orthopäden und Orthopädinnen offenbar zu wenig genutzt. Darauf deuten die Ergebnisse einer Fragebogenstudie an der Sahlgrenska-Universität in Schweden hin.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Accuracy of portable navigation during THA in patients with severe developmental dysplasia of hip