Accuracy of Cup Alignment in Total Hip Arthroplasty: A Comparison Between Portable Navigation and Goniometer

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2024 Nov 22

PMID 39575353

Authors

Tomonori Tetsunaga

Tomoko Tetsunaga

Kazuki Yamada

Takashi Koura

Tomohiro Inoue

Ryuichiro Okuda

Yasutaka Masada

Sho Muguruma

Yuki Okazaki

Toshifumi Ozaki

Affiliations

Soon will be listed here.

Abstract

Background Navigation systems, including portable navigation systems, used for total hip arthroplasty (THA) are useful for achieving higher cup alignment accuracy. NAVBIT, a newly available portable navigation system, uses a unique registration method, the table tilt registration. However, its accuracy is unclear. This retrospective study aimed to investigate whether THA with a portable navigation system in the lateral position with the flip technique is more accurate than THA with a cup goniometer in the supine or lateral positions. Methodology This study included 96 consecutive patients (77 women, 19 men) who underwent primary cementless THA using either a portable navigation system in the lateral position with the flip technique or a cup goniometer in the supine or lateral positions. The average age of the patients was 66.8 years (range = 29-91) and the average body mass index was 24.6 kg/m (range = 17.5-39.9). The accuracy of cup orientation was compared among the three groups. Results The absolute values of the difference in cup inclination and anteversion with the NAVBIT (2.1 ± 1.7°, 2.0 ± 1.4°) were smaller than that with the cup goniometer in the supine (3.4 ± 2.4°, 3.4 ± 2.2°) and lateral decubitus positions (3.4 ± 2.5°, 5.0 ± 3.5°). Overall, 91%, 64.5%, and 56.3% were within 5° of the target angles in the navigation, supine goniometer, and lateral goniometer groups, respectively. Conclusions The accuracy of cup alignment with the portable navigation system using the flip technique was significantly higher than that with the cup goniometer in the supine and lateral decubitus positions.

Citing Articles

Accuracy of Cup Alignment in Total Hip Arthroplasty: A Comparison Between Portable Navigation and Goniometer.

Tetsunaga T, Tetsunaga T, Yamada K, Koura T, Inoue T, Okuda R Cureus. 2024; 16(11):e74176.

PMID: 39575353 PMC: 11581462. DOI: 10.7759/cureus.74176.

References

Ueoka K, Kabata T, Kajino Y, Yoshitani J, Ueno T, Tsuchiya H . 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. 2019; 34(11):2686-2691. DOI: 10.1016/j.arth.2019.06.002. View

Tanino H, Mitsutake R, Ito H . Measurement accuracy of the acetabular cup position using an inertial portable hip navigation system with patients in the lateral decubitus position. Sci Rep. 2024; 14(1):1158. PMC: 10784560. DOI: 10.1038/s41598-024-51785-2. View

Otero J, Fehring K, Martin J, Odum S, Fehring T . Variability of Pelvic Orientation in the Lateral Decubitus Position: Are External Alignment Guides Trustworthy?. J Arthroplasty. 2018; 33(11):3496-3501. DOI: 10.1016/j.arth.2018.07.021. View

Kishimura Y, Minoda Y, Mizokawa S, Sugama R, Ohta Y, Nakamura H . Cup alignment in total hip arthroplasty using the muscle-sparing modified Watson-Jones approach-comparison between lateral and supine positions. Int Orthop. 2019; 43(11):2477-2483. DOI: 10.1007/s00264-019-04316-y. View

Lass R, Kubista B, Olischar B, Frantal S, Windhager R, Giurea A . Total hip arthroplasty using imageless computer-assisted hip navigation: a prospective randomized study. J Arthroplasty. 2013; 29(4):786-91. DOI: 10.1016/j.arth.2013.08.020. View

Hayashi S, Kuroda Y, Nakano N, Matsumoto T, Kamenaga T, Maeda T . Comparing the accuracy of three-dimensional mini-optical portable navigation and accelerometer-based portable navigation system for acetabular cup placement during total hip arthroplasty. Arch Orthop Trauma Surg. 2022; 143(7):3759-3766. DOI: 10.1007/s00402-022-04583-2. View

Milone M, Schwarzkopf R, Meere P, Carroll K, Jerabek S, Vigdorchik J . Rigid Patient Positioning is Unreliable in Total Hip Arthroplasty. J Arthroplasty. 2017; 32(6):1890-1893. DOI: 10.1016/j.arth.2016.12.038. View

Tetsunaga T, Yamada K, Tetsunaga T, Furumatsu T, Sanki T, Kawamura Y . Comparison of the accuracy of CT- and accelerometer-based navigation systems for cup orientation in total hip arthroplasty. Hip Int. 2020; 31(5):603-608. DOI: 10.1177/1120700020904940. View

Murphy W, Yun H, Hayden B, Kowal J, Murphy S . The Safe Zone Range for Cup Anteversion Is Narrower Than for Inclination in THA. Clin Orthop Relat Res. 2018; 476(2):325-335. PMC: 6259696. DOI: 10.1007/s11999.0000000000000051. View

10.

McCarthy T, Alipit V, Nevelos J, Elmallah R, Mont M . Acetabular Cup Anteversion and Inclination in Hip Range of Motion to Impingement. J Arthroplasty. 2016; 31(9 Suppl):264-8. DOI: 10.1016/j.arth.2016.01.067. View

11.

Tetsunaga T, Tetsunaga T, Yamada K, Koura T, Inoue T, Okuda R . Accuracy of Cup Alignment in Total Hip Arthroplasty: A Comparison Between Portable Navigation and Goniometer. Cureus. 2024; 16(11):e74176. PMC: 11581462. DOI: 10.7759/cureus.74176. View

12.

Lee Y, Yoon T . Error in acetabular socket alignment due to the thick anterior pelvic soft tissues. J Arthroplasty. 2008; 23(5):699-706. DOI: 10.1016/j.arth.2007.06.012. View

13.

Hasegawa M, Naito Y, Tone S, Sudo A . Accuracy of a novel accelerometer-based navigation (Naviswiss) for total hip arthroplasty in the supine position. BMC Musculoskelet Disord. 2022; 23(1):537. PMC: 9166425. DOI: 10.1186/s12891-022-05495-3. View

14.

Shahbazi P, Jalilvand A, Ghaseminejad-Raeini A, Ghaderi A, Sheikhvatan M, Fallah Y . Risk Factors for Dislocation following Total Hip Arthroplasty in Developmental Dysplasia of the Hip: A Systematic Review and Meta-Analysis. Int Orthop. 2023; 47(12):3063-3075. DOI: 10.1007/s00264-023-05949-w. View

15.

Kanazawa M, Nakashima Y, Ohishi M, Hamai S, Motomura G, Yamamoto T . Pelvic tilt and movement during total hip arthroplasty in the lateral decubitus position. Mod Rheumatol. 2015; 26(3):435-40. DOI: 10.3109/14397595.2015.1092914. View

16.

Murray D . The definition and measurement of acetabular orientation. J Bone Joint Surg Br. 1993; 75(2):228-32. DOI: 10.1302/0301-620X.75B2.8444942. View

17.

Tetsunaga T, Yamada K, Tetsunaga T, Sanki T, Kawamura Y, Ozaki T . An accelerometer-based navigation system provides acetabular cup orientation accuracy comparable to that of computed tomography-based navigation during total hip arthroplasty in the supine position. J Orthop Surg Res. 2020; 15(1):147. PMC: 7161129. DOI: 10.1186/s13018-020-01673-y. View

18.

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

19.

Danoff J, Bobman J, Cunn G, Murtaugh T, Gorroochurn P, Geller J . Redefining the Acetabular Component Safe Zone for Posterior Approach Total Hip Arthroplasty. J Arthroplasty. 2015; 31(2):506-11. DOI: 10.1016/j.arth.2015.09.010. View

20.

Buller L, McLawhorn A, Romero J, Sculco P, Mayman D . Accuracy and Precision of Acetabular Component Placement With Imageless Navigation in Obese Patients. J Arthroplasty. 2019; 34(4):693-699. DOI: 10.1016/j.arth.2018.12.003. View