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Does a computed tomography-based navigation system reduce the risk of dislocation after total hip arthroplasty in patients with osteonecrosis of the femoral head? A propensity score analysis

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  • Artificial Skin, Muscle, Bone / Joint, Neuron
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Abstract

This study aimed to investigate whether use of a computed tomography (CT)-based navigation system reduce the risk of dislocation after total hip arthroplasty (THA) in patients with osteonecrosis of the femoral head (ONFH). A total of 271 hips from 192 consecutive patients that underwent primary THA for ONFH were included. There were 110 hips in non-navigation group, and 161 hips in navigation group. After applying exclusion criteria, 209 hips from 149 patients were selected for analysis. Clinical outcomes and complication rates were evaluated, and implant alignments were also calculated. To identify whether the navigation system was useful to prevent dislocation, the inverse probability of treatment-weighted Cox regression analysis using a propensity score in relationship to sex, age at surgery, body mass index, and femoral head size was performed. No significant difference was observed in clinical scores between both groups. Dislocation was significantly lower in the navigation group (3 hips, 2.7%) than in the non-navigation group (11 hips, 11.2%; p = 0.012), whereas periprosthetic joint infection and aseptic loosening did not differ between the groups. Variance of cup inclination and anteversion angles was smaller in the navigation group than in the non-navigation group (p < 0.001). Use of the CT-based navigation system (hazard ratio; 0.26, 95% confidence interval, 0.07–0.98; p = 0.047) turned out to be the predictor for preventing dislocation. In conclusion, use of the CT-based navigation system provided a precise placement of components, and thus helps to prevent dislocation in patients with ONFH in the propensity score analysis.

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Acknowledgements

This work was partially supported by the Health Labor Sciences Research Grant H29-NANCHI-IPPAN#053.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Kazuma Takashima, Takashi Sakai, Hidetoshi Hamada & Masaki Takao

  2. Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi, Japan

    Takashi Sakai

  3. Department of Mathematics and Statistics, Amherst College, Seeley Mudd Building, Amherst, MA, 01002, USA

    Shu Amano

  4. Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan

    Wataru Ando & Nobuhiko Sugano

  5. Department of Data Science, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, Japan

    Toshimitsu Hamasaki

  6. Center of Arthroplasty, Kyowakai Hospital, 1-24-1 Kishibe-kita, Suita, Osaka, Japan

    Nobuo Nakamura

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  1. Kazuma Takashima
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  2. Takashi Sakai
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  3. Shu Amano
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  4. Hidetoshi Hamada
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  8. Nobuo Nakamura
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  9. Nobuhiko Sugano
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Correspondence to Takashi Sakai.

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Takashima, K., Sakai, T., Amano, S. et al. Does a computed tomography-based navigation system reduce the risk of dislocation after total hip arthroplasty in patients with osteonecrosis of the femoral head? A propensity score analysis. J Artif Organs 23, 247–254 (2020). https://doi.org/10.1007/s10047-020-01158-z

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  • DOI: https://doi.org/10.1007/s10047-020-01158-z

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