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Accuracy of portable navigation during THA in patients with severe developmental dysplasia of hip

  • Hip Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Correct cup placement in total hip arthroplasty (THA) for patients with developmental dysplasia of the hip (DDH) is considerably difficult. This study aimed to analyze the orientation accuracy of cup insertion during THA using a portable navigation system in patients with DDH.

Materials and methods

In this retrospective cohort study, we analyzed data from 64 patients who underwent THA using infrared stereo camera-matching portable navigation. Patients underwent THA via the anterolateral approach in the lateral decubitus position. Navigation records for intraoperative cup angles, postoperative cup angles measured on computed tomography (CT) images, and cup angle measurement differences were measured and compared between patients with non-DDH/mild DDH and severe DDH. Furthermore, the predictive factors for outliers of accurate acetabular cup placement were analyzed.

Results

The average measurement absolute abduction differences (postoperative CT-navigation record) were 3.9 ± 3.5° (severe DDH) and 3.3 ± 2.6° (non-DDH/ mild DDH), and the anteversion differences were 4.7 ± 3.4° (severe DDH) and 2.3 ± 2.1° (non-DDH/ mild DDH). The anteversion difference was different between the two groups. Multivariate analysis showed that the navigation difference (absolute difference in anteversion between postoperative CT and navigation records of > 5°) was significantly associated with severe DDH (odds ratio [OR]: 3.3; p = 0.049, 95% confidence interval [CI]: 1.0–11.1) and posterior pelvic tilt (OR: 1.1; p = 0.042, 95% CI: 1.0–1.27).

Conclusions

In patients with severe DDH, it is important to pay close attention during THA using portable navigation. However, the average difference was < 5º even in patients with severe DDH, and the accuracy may be acceptable in a clinical setting when the cost is considered.

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Data availability

All data generated or analyzed during this study have been included in this published article.

Code Availability

Not applicable.

Abbreviations

DDH:

developmental dysplasia of the hip

THA:

total hip arthroplasty

OR:

odds ratio

CI:

confidence interval

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Acknowledgements

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Funding

No funding was received for this study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Shinya Hayashi, Yuichi Kuroda, Naoki Nakano, Tomoyuki Matsumoto, Tomoyuki Kamenaga, Masanori Tsubosaka & Ryosuke Kuroda

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  1. Shinya Hayashi
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  2. Yuichi Kuroda
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  3. Naoki Nakano
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  4. Tomoyuki Matsumoto
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  5. Tomoyuki Kamenaga
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  6. Masanori Tsubosaka
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  7. Ryosuke Kuroda
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Contributions

SH participated in the study design, drafting of the manuscript, and data collection. YK performed data collection and drafting of the manuscript. NN participated in data collection and drafting of the manuscript. TM participated in study design and helped revise the manuscript. TK participated in data collection and drafting of the manuscript. MT performed data collection and drafting of the manuscript. RK participated in the study design and helped revise the manuscript. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Shinya Hayashi.

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Ethical approval

The study protocol was approved by our Institutional Review Board on September 8, 2011 (No. 1220), and the study was performed in accordance with the ethical standards of the 1964 Declaration of Helsinki.

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Informed consent for participation in the study was obtained from all participants.

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The authors declare that they have no conflicts of interest.

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Hayashi, S., Kuroda, Y., Nakano, N. et al. Accuracy of portable navigation during THA in patients with severe developmental dysplasia of hip. Arch Orthop Trauma Surg 144, 2429–2435 (2024). https://doi.org/10.1007/s00402-024-05338-x

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  • DOI: https://doi.org/10.1007/s00402-024-05338-x

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