Clinical Orthopaedics and Related Research®

, Volume 470, Issue 11, pp 3054–3059

Does CT-Based Navigation Improve the Long-Term Survival in Ceramic-on-Ceramic THA?

  • Nobuhiko Sugano
  • Masaki Takao
  • Takashi Sakai
  • Takashi Nishii
  • Hidenobu Miki
Symposium: Papers Presented at the 2011 Meeting of the International Hip Society

DOI: 10.1007/s11999-012-2378-4

Cite this article as:
Sugano, N., Takao, M., Sakai, T. et al. Clin Orthop Relat Res (2012) 470: 3054. doi:10.1007/s11999-012-2378-4

Abstract

Background

Although navigated THA provides improved precision in implant positioning and alignment, it is unclear whether these translate into long-term implant survival.

Questions/Purposes

We compared survivorship, dislocation rate, and incidence of radiographic failures such as loosening and bearing breakage after THA with and without navigation at a minimum 10-year followup.

Methods

We retrospectively reviewed 46 patients (60 hips) and 97 patients (120 hips) receiving THA with or without a CT-based navigation system, respectively, using cementless THA ceramic-on-ceramic bearing couples. There were no differences in age, sex, diagnosis, height, weight, BMI, or preoperative clinical score between groups. We evaluated survivorship, mode of acetabular and femoral component fixation, osteolysis, and implant wear or breakage at a minimum followup of 10 years (average, 11 years; range, 10–13 years).

Results

Survival at 13 years was 100% with navigation and 95.6% (95% CI, 88.4%–98.4%) without navigation. With navigation, all cups were placed within a zone of 40° (range, 30°–50°) of radiographic inclination and 15° (range, 5°–15°) of radiographic anteversion; without navigation, 31 cups (26%) were placed outside this zone. Hips treated without navigation had a higher rate of dislocation (8%) than the navigated cases (0%). Revision was performed in four nonnavigated cases, all of which showed evidence of neck impingement on the ceramic liner. Moreover, seven other cases without navigation showed posterior neck erosion on radiographs. These 11 impingement-related mechanical complications correlated with cup malorientation, and the incidence of impingement-related complications was higher in nonnavigated cases.

Conclusions

Navigation reduced the rates of dislocation and impingement-related mechanical complications leading to revision in cementless THA using ceramic-on-ceramic bearing couples over a minimum 10-year followup.

Level of Evidence

Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

Copyright information

© The Association of Bone and Joint Surgeons® 2012

Authors and Affiliations

  • Nobuhiko Sugano
    • 1
  • Masaki Takao
    • 2
  • Takashi Sakai
    • 2
  • Takashi Nishii
    • 1
  • Hidenobu Miki
    • 3
  1. 1.Department of Orthopaedic Medical EngineeringOsaka University Graduate School of MedicineOsakaJapan
  2. 2.Department of Orthopaedic SurgeryOsaka University Graduate School of MedicineSuitaJapan
  3. 3.Department of Orthopaedic SurgeryOsaka National HospitalOsakaJapan

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