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Handheld hip navigation provided real-time positioning data, decreased fluoroscopy time
ORLANDO, Fla. — The amount of fluoroscopy time was greatly reduced during direct-anterior approach total hip arthroplasty when surgeons used a handheld navigation unit instead of fluoroscopy during implant positioning, according to research presented at the Current Concepts in Joint Replacement Winter Meeting.
Edwin P. Su, MD, from Hospital for Special Surgery in New York, discussed results with HipAlign (OrthAlign), which involves imageless technology that includes sensors that help create a reference plane and provide data on hip positioning intraoperatively.
“It offered the potential for accurate cup positioning during anterior total hip without X-ray and just being familiar with KneeAlign (OrthAlign), I knew how helpful that real-time data could be,” Su said, noting the system calls for inserting pins in the patient’s iliac crest to establish a rigid reference frame for the device.
He investigated the system in hopes that it might reduce the amount of radiation he was exposed to when performing the direct anterior approach for THA. Su and colleagues prospectively studied use of the navigated system and fluoroscopy in 50 hips each.
“The results are we did not find any hardware failures or abandonment of navigation. I was pleasantly surprised that patients did not complain of the iliac crest pin sites,” Su said.
The navigation system provided helpful additional information about pelvic tilt and rotation. Furthermore, it added about 5.5 minutes on average per procedure for insertion of the pins, registration, cup positioning and removal of the system, according to Su.
“That does not account for the time you save in moving ‘fluoro’ in and out,” he said.
Concerning the position of the implanted cups, the investigators saw no difference between the groups with regard to mean inclination or abduction.
“We did see a significant difference in the ‘fluoro,’ which was pleasing to me,” Su said, noting fluoroscopic time was decreased by 44%. – by Susan M. Rapp
Reference:
Su EP. Paper #55. Presented at: Current Concepts in Joint Replacement Winter Meeting; Dec. 13-16, 2017; Orlando, Florida.
Disclosure: Su reports he receives stock options from the OrthAlign for advisory board, receives consulting fees from Smith & Nephew for the hip advisory board and receives consulting fees from United Orthopedic.