Digitalized Analyses of Intraoperative Acetabular Component Position Using Image-matching Technique in Total Hip Arthroplasty

Overview

Journal Bone Joint Res

Date 2020 Jul 31

PMID 32728432

Citations 3

Authors

Shinya Kawahara

Toshihiko Hara

Taishi Sato

Kazuki Kitade

Takeshi Shimoto

Tetsuro Nakamura

Taro Mawatari

Hidehiko Higaki

Yasuharu Nakashima

Affiliations

Soon will be listed here.

Abstract

Aims: Appropriate acetabular component placement has been proposed for prevention of postoperative dislocation in total hip arthroplasty (THA). Manual placements often cause outliers in spite of attempts to insert the component within the intended safe zone; therefore, some surgeons routinely evaluate intraoperative pelvic radiographs to exclude excessive acetabular component malposition. However, their evaluation is often ambiguous in case of the tilted or rotated pelvic position. The purpose of this study was to develop the computational analysis to digitalize the acetabular component orientation regardless of the pelvic tilt or rotation.

Methods: Intraoperative pelvic radiographs of 50 patients who underwent THA were collected retrospectively. The 3D pelvic bone model and the acetabular component were image-matched to the intraoperative pelvic radiograph. The radiological anteversion (RA) and radiological inclination (RI) of the acetabular component were calculated and those measurement errors from the postoperative CT data were compared relative to those of the 2D measurements. In addition, the intra- and interobserver differences of the image-matching analysis were evaluated.

Results: Mean measurement errors of the image-matching analyses were significantly small (2.5° (SD 1.4°) and 0.1° (SD 0.9°) in the RA and RI, respectively) relative to those of the 2D measurements. Intra- and interobserver differences were similarly small from the clinical perspective.

Conclusion: We have developed a computational analysis of acetabular component orientation using an image-matching technique with small measurement errors compared to visual evaluations regardless of the pelvic tilt or rotation.Cite this article: 2020;9(7):360-367.

Citing Articles

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References

Inaba Y, Kobayashi N, Ike H, Kubota S, Saito T . The current status and future prospects of computer-assisted hip surgery. J Orthop Sci. 2016; 21(2):107-15. DOI: 10.1016/j.jos.2015.10.023. View

Nishihara S, Sugano N, Nishii T, Ohzono K, Yoshikawa H . Measurements of pelvic flexion angle using three-dimensional computed tomography. Clin Orthop Relat Res. 2003; (411):140-51. DOI: 10.1097/01.blo.0000069891.31220.fd. View

Inoue D, Kabata T, Maeda T, Kajino Y, Fujita K, Hasegawa K . Value of computed tomography-based three-dimensional surgical preoperative planning software in total hip arthroplasty with developmental dysplasia of the hip. J Orthop Sci. 2015; 20(2):340-6. DOI: 10.1007/s00776-014-0683-3. View

Jingushi S, Mizu-Uchi H, Nakashima Y, Yamamoto T, Mawatari T, Iwamoto Y . 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. 2007; 22(7):1074-8. DOI: 10.1016/j.arth.2007.04.022. View

Hara D, Nakashima Y, Hamai S, Higaki H, Ikebe S, Shimoto T . Dynamic Hip Kinematics During the Golf Swing After Total Hip Arthroplasty. Am J Sports Med. 2016; 44(7):1801-9. DOI: 10.1177/0363546516637179. View

Gurgel H, Croci A, Cabrita H, Vicente J, Leonhardt M, Rodrigues J . Acetabular component positioning in total hip arthroplasty with and without a computer-assisted system: a prospective, randomized and controlled study. J Arthroplasty. 2013; 29(1):167-71. DOI: 10.1016/j.arth.2013.04.017. View

Lewinnek G, Lewis J, Tarr R, COMPERE C, Zimmerman J . Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am. 1978; 60(2):217-20. View

Dorr L, Wolf A, Chandler R, Conaty J . Classification and treatment of dislocations of total hip arthroplasty. Clin Orthop Relat Res. 1983; (173):151-8. View

Parratte S, Argenson J . Validation and usefulness of a computer-assisted cup-positioning system in total hip arthroplasty. A prospective, randomized, controlled study. J Bone Joint Surg Am. 2007; 89(3):494-9. DOI: 10.2106/JBJS.F.00529. View

10.

Nakashima Y, Hirata M, Akiyama M, Itokawa T, Yamamoto T, Motomura G . Combined anteversion technique reduced the dislocation in cementless total hip arthroplasty. Int Orthop. 2013; 38(1):27-32. PMC: 3890140. DOI: 10.1007/s00264-013-2091-2. View

11.

Grammatopoulos G, Gofton W, Cochran M, Dobransky J, Carli A, Abdelbary H . Pelvic positioning in the supine position leads to more consistent orientation of the acetabular component after total hip arthroplasty. Bone Joint J. 2018; 100-B(10):1280-1288. DOI: 10.1302/0301-620X.100B10.BJJ-2018-0134.R1. View

12.

Hassan D, Johnston G, Dust W, Watson G, Dolovich A . Accuracy of intraoperative assessment of acetabular prosthesis placement. J Arthroplasty. 1998; 13(1):80-4. DOI: 10.1016/s0883-5403(98)90079-1. View

13.

Kim Y, Kwon S, Sun D, Han S, Maloney W . Modified posterior approach to total hip arthroplasty to enhance joint stability. Clin Orthop Relat Res. 2008; 466(2):294-9. PMC: 2505149. DOI: 10.1007/s11999-007-0056-8. View

14.

Matsuki K, Matsuki K, Mu S, Yamaguchi S, Ochiai N, Sasho T . In vivo 3-dimensional analysis of scapular kinematics: comparison of dominant and nondominant shoulders. J Shoulder Elbow Surg. 2011; 20(4):659-65. DOI: 10.1016/j.jse.2010.09.012. View

15.

Takao M, Nishii T, Sakai T, Sugano N . Postoperative Limb-Offset Discrepancy Notably Affects Soft-Tissue Tension in Total Hip Arthroplasty. J Bone Joint Surg Am. 2016; 98(18):1548-54. DOI: 10.2106/JBJS.15.01073. View

16.

Schmalzried T, Guttmann D, Grecula M, Amstutz H . The relationship between the design, position, and articular wear of acetabular components inserted without cement and the development of pelvic osteolysis. J Bone Joint Surg Am. 1994; 76(5):677-88. DOI: 10.2106/00004623-199405000-00008. View

17.

Hohmann E, Bryant A, Tetsworth K . A comparison between imageless navigated and manual freehand technique acetabular cup placement in total hip arthroplasty. J Arthroplasty. 2011; 26(7):1078-82. DOI: 10.1016/j.arth.2010.11.009. View

18.

Hambright D, Hellman M, Barrack R . Intra-operative digital imaging: assuring the alignment of components when undertaking total hip arthroplasty. Bone Joint J. 2018; 100-B(1 Supple A):36-43. PMC: 6424435. DOI: 10.1302/0301-620X.100B1.BJJ-2017-0596.R1. View

19.

Key S, Scott G, Stammers J, Freeman M, Pinskerova V, Field R . Does lateral lift-off occur in static and dynamic activity in a medially spherical total knee arthroplasty? A pulsed-fluoroscopic investigation. Bone Joint Res. 2019; 8(5):207-215. PMC: 6548977. DOI: 10.1302/2046-3758.85.BJR-2018-0237.R1. View

20.

Minoda Y, Kadowaki T, Kim M . Acetabular component orientation in 834 total hip arthroplasties using a manual technique. Clin Orthop Relat Res. 2006; 445:186-91. DOI: 10.1097/01.blo.0000201165.82690.f8. View