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Study: Computer navigation enhanced accuracy of THA procedures
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BIRMINGHAM, England — Imageless computer navigation can help surgeons better restore limb length and offset during total hip arthroplasty, according to a presenter here at the British Orthopaedic Association Congress.
“Ultimately, the navigation gives high accuracy and precision as compared to the radiographs and it has excellent clinical results,” Kamal Deep, FRCS(Orth), of Golden Jubilee National Hospital, Clydebank, United Kingdom.
Deep and colleagues compared measurements they made using THA Pro computer navigation software (Aesculap AG; Tuttlingen, Germany) of 229 patients who underwent total hip arthroplasty (THA) between 2008 and 2012 to the same measurements they made using the patients’ postoperative radiographs. Patients with partial or lost surgical records were excluded from the study.
Although it was a retrospective study, data were collected prospectively, Deep said.
Cup position is an increasingly important issue in THA, he said, and recent research from a U.S. center shows “only two-thirds of the cups are in desired position.”
“Intraoperative navigation measurements had high precision and specificity for determining cup abduction and anteversion (precision >95%, specificity >90%). Accuracy for determining cup abduction was 96.13% compared to 72.2% for cup anteversion,” according to the study abstract. The mean cup abduction measurements were 41º (SD 5.03) with navigation and 40.35º (SD 5.81) with postoperative radiographs, based on the findings.
There was a 0.98-mm difference in leg length between the two types of measurements and investigators found a 1-mm difference between the offset measured with each method. Deep said the two differences in measurement were not statistically significant. The Oxford Hip Scores improved significantly after THA. There was a greater than 99% rate of patient satisfaction and none of the hips dislocated, he said.
Deep said the study would have been stronger if there was a control group and if CT been used instead of radiographs.
“CT scans would have been a better tool to assess the navigation, but our routine practice in the U.K. is to just do postoperative X-rays rather than CTs,” he said.
Reference:
Deep K. Paper #869. Presented at: British Orthopaedic Association Congress. Oct.1-4, 2013. Birmingham, England.
Disclosure: Deep is on the speaker’s bureau for or does paid presentations for, is a paid consultant to, and receives research support from Aesculap/B. Braun.