Abstract
Background
The goal of the current prospective randomised radiological study was to determine the accuracy of conventional and computer-assisted femoral component implantation in surface arthroplasty (SRA).
Methods
We analysed on standard radiographs the femoral component positions after 30 conventional instrumented (Group 1) and 30 navigated (Group 2) SRA femoral components. We evaluated: varus or valgus orientation, horizontal femoral offset and translation of the component.
Results
The tendency to implant the femoral component in mild valgus position (2.8° in Group 1 compared to 2.1° in Group 2), more distally and ventrally in the femoral neck (in Group 1) and with femoral off-set increase (4.8 mm in Group 1 compared to 3.4 mm in Group 2) was found.
Conclusions
The navigation system enables a more accurate insertion of the femoral component.
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References
Amstutz HC, Campbell PA, Duff ML (2004) Fracture of the neck of the femur after surface arthroplasty of the hip. J Bone Joint Surg 86A:1874–1877
Vendittoli PA, Lavigne M, Winzenrieth R, Plamondon D, Nuno N (2006) Factors affecting hip range of motion in surface replacement arthroplasty. Hip Int 16(Suppl):106
Itayem R, Arndt A, Nistor L, McMinn D, Lundberg A (2005) Stability of the Birmingham hip resurfacing arthroplasty at two years. A radiostereophotogrammetric analysis study. J Bone Joint Surg 87B:158–162
Glyn-Jones S, Gill HS, McLardy-Smith P, Murray DW (2004) Roentgen stereophotogrammetric analysis of the Birmingham hip resurfacing arthroplasty. J Bone Joint Surg 86B:172–176
Daniel J, Pynsent PB, McMinn DJW (2003) Metal-on-metal resurfacing of the hip in patients under the age of 55 years with osteoarthritis. J Bone Joint Surg 86B:177–184
Alberton GM, High WA, Morrey BF (2002) Dislocation after revision total hip arthroplasty: an analysis of risk factors and treatment options. J Bone Joint Surg 84A:1788–1792
Kishida Y, Sugano N, Nishii T, Miki H, Yamaguchi K, Yoshikawa H (2004) Preservation of the bone mineral density of the femur after surface replacement of the hip. J Bone Joint Surg 86B:185–189
Silva M, Lee KH, Heisel Ch, delaRosa MA, Schmalzried TP (2004) The biomechanical results of total hip resurfacing arthroplasty. J Bone Joint Surg 86A:40–46
Bogoch ER, Fornasier VL, Capello WN (1982) The femoral head remnant in resurfacing arthroplasty. Clin Orthop 167:92–105
Ito K, Minka MA, Leunig M, Werlen S, Ganz R (2001) Femoroacetabular impingement and the cam-effect. A MRI-based quantitative anatomical study of the femoral head-neck offset. J Bone Joint Surg 83B:171–176
Nötzli HP, Wyss TF, Stoecklin CH, Schmid MR, Treiber K, Hodler J (2002) The contour of the femoral head-neck junction as a predictor for the risk of the anterior impingement. J Bone Joint Surg 84B:556–560
Meyer DC, Beck M, Ellis T, Ganz R, Leunig M (2006) Comparison of six radiographic projections to assess femoral head/neck asphericity. Clin Orthop 445:181–185
D´Lima DD, Chen PC, Colwell CW Jr (2001) Optimizing acetabular component position to minimize impingement and reduce contact stress. J Bone Joint Surg 83A:87–91
Berry DJ (1999) Dislocation. In: Steinberg ME, Garino JP (eds) Revision total hip arthroplasty. Lippincott, Philadelphia, pp 463–481
Beaulé PE, Lee JL, LeDuff MJ, Amstutz HC, Ebramzadeh E (2004) Orientation of the femoral component in surface arthroplasty of the hip. A biomechanical and clinical analysis. J Bone Joint Surg 86A:2015–2021
Bernsmann K, Langlotz U, Ansari B, Wiese M (2000) Computer assisted navigated cup placement in hip arthroplasty—application study in clinical routine. Z Orthop 138:515–521
DiGioia AM, Jaramaz B, Blackwell M, Simon DA, Morgan F, Moody JE, Nikou C, Colgan BD, Aston CA, Labarca RS, Kischell E, Kanade T (1998) The Otto Aufranc Award. Image guided navigation system to measure intraoperatively actabular implant alignment. Clin Orthop 355:8–22
Haaker R, Tiedjen K, Rubenthaler F, Stockheim M (2003) Computer assisted navigated cup placement in primary and secondary dysplastic hips. Z Orthop 141:105–111
Jaramaz B, DiGioia AM, Blackwell M, Nikou C (1998) Computer assisted measurement of cup placement in total hip replacement. Clin Orthop 354:70–81
Kiefer H (2003) OrthoPilot cup navigation—how to optimise cup positioning? Int Orthop 27(S1):S37–S42
Ottersbach A, Haaker R (2005) Optimization of cup positioning in THA—comparison between conventional mechanical instrumentation and computer-assisted implanted cups by using the OrthoPilot navigation system. Z Orthop 143:611–615
Saxler G, Marx A, Vabndervelde D (2004) A comparison of free-hand and computer assisted cup placement in total hip arthroplasty. Z Orthop 142:286–291
Štipčák V, Stoklas J, Hart R, Janeček M (2004) Implantation of a non-cemented acetabulum with the use of a navigation system. Acta Chir Orthop Traumatol Cech 71:288–291
Richolt JA, Rittmeister ME (2006) Misinterpretation of the anteversion in computer-assisted acetabular cup navigation as a result of a simplified palpation method of the frontal pelvic plane. An untrasonographic assessment. Z Orthop 144:305–310
Štipčák V, Hart R, Kučera B (2006) Our experience with an image guided navigation system for accurate alignment in total hip replacement by minimally invasive posterolateral surgery. Acta Chir Orthop Traumatol Cech 73:350–352
Hess T, Gampe T, Köttgen C, Szawlowski B (2004) Intraoperative navigation for hip resurfacing. Methods and first results. Orthopade 33:1183–1193
Bäthis H, Perlick L, Tingart M, Kalteis T, Grifka J (2007) Comparison of fluoroscopic and landmark-based technique with the Vector-Vision system. In: Stiehl JB, Konermann WH, Haaker RG, DiGioia AM (eds) Navigation and MIS in orthopedic surgery. Springer, Heidelberg, pp 359–364
Chandler M, Kowalski RSZ, Watkins ND, Briscoe A, New AMR (2006) Cementing techniques in hip resurfacing. Proc IMechE 220(part H):321–331
Siebel T, Maubach S, Morlock MM (2006) Lessons learned from early clinical experience and results of 300 ASR® hip resurfacing implantations. Proc IMechE 220(part H):345–353
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Hart, R., Šváb, P. & Filan, P. Intraoperative navigation in hip surface arthroplasty: a radiographic comparative analysis study. Arch Orthop Trauma Surg 128, 429–434 (2008). https://doi.org/10.1007/s00402-007-0540-3
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DOI: https://doi.org/10.1007/s00402-007-0540-3