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Improving Cup Positioning Using a Mechanical Navigation Instrument

  • Symposium: Papers Presented at the Hip Society Meetings 2010
  • Published:
Clinical Orthopaedics and Related Research®

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.

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Author information

Authors and Affiliations

  1. Center for Computer Assisted and Reconstructive Surgery, New England Baptist Hospital, Tufts University School of Medicine, 125 Parker Hill Avenue, Suite 545, Boston, MA, 02120, USA

    Simon D. Steppacher MD, Jens H. Kowal PhD & Stephen Barry Murphy MD

  2. Department of Orthopaedic Surgery, Inselspital, University of Bern, Bern, Switzerland

    Simon D. Steppacher MD

  3. ARTORG Center for Biomedical Engineering Research, ISTB-Institute for Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland

    Jens H. Kowal PhD

Authors
  1. Simon D. Steppacher MD
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  2. Jens H. Kowal PhD
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  3. Stephen Barry Murphy MD
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Corresponding author

Correspondence to Stephen Barry Murphy MD.

Additional information

One or more of the authors (SDS) has received funding from the Swiss National Science Foundation (SNSF). One author (JHK) is a consultant for Surgical Planning Associates, Inc and one author (SBM) is a principal of Surgical Planning Associates, Inc.

Each author certifies that his institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent was obtained.

This work was performed at the Center for Computer Assisted and Reconstructive Surgery, New England Baptist Hospital, Tufts University School of Medicine, Boston, MA, USA.

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Steppacher, S.D., Kowal, J.H. & Murphy, S.B. Improving Cup Positioning Using a Mechanical Navigation Instrument. Clin Orthop Relat Res 469, 423–428 (2011). https://doi.org/10.1007/s11999-010-1553-8

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  • DOI: https://doi.org/10.1007/s11999-010-1553-8

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