Clinical Orthopaedics and Related Research

, Volume 467, Issue 5, pp 1341–1347 | Cite as

Femoral Component Positioning in Hip Resurfacing With and Without Navigation

  • Muthu Ganapathi
  • Pascal-André Vendittoli
  • Martin Lavigne
  • Klaus-Peter Günther
Original Article


Early failures after hip resurfacing often are the result of technical errors in placing the femoral component. We asked whether image-free computer navigation decreased the number of outliers compared with the conventional nonnavigated technique. We retrospectively compared 51 consecutive hip resurfacings performed using image-free computer navigation with 88 consecutive hip resurfacings performed without navigation. Patient demographics were similar. There were no differences in the average native femoral neck-shaft angles, planned stem-shaft angles, or postoperative stem-shaft angles. However, when the postoperative stem-shaft angle was compared with the planned stem-shaft angle, there were 33 patients (38%) in the nonnavigated group with a deviation greater than 5° in contrast to none in the navigated group. Notching was present in four patients in the nonnavigated group and none in the navigated group. The average operative time was 111 minutes for the navigated group and 105 minutes for the nonnavigated group. Image-free navigation decreased the number of patients with potentially undesirable implant placements.

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


  1. 1.
    Amstutz HC, Beaule PE, Dorey FJ, Le Duff MJ, Campbell PA, Gruen TA. Metal-on-metal hybrid surface arthroplasty: two to six-year follow-up study. J Bone Joint Surg Am. 2004;86:28–39.PubMedGoogle Scholar
  2. 2.
    Amstutz HC, Campbell PA, Le Duff MJ. Fracture of the neck of the femur after surface arthroplasty of the hip. J Bone Joint Surg Am. 2004;86:1874–1877.PubMedGoogle Scholar
  3. 3.
    Anglin C, Masri BA, Tonetti J, Hodgson AJ, Greidanus NV. Hip resurfacing femoral neck fracture influenced by valgus placement. Clin Orthop Relat Res. 2007;465:71–79.PubMedGoogle Scholar
  4. 4.
    Bauwens K, Matthes G, Wich M, Gebhard F, Hanson B, Ekkernkamp A, Stengel D. Navigated total knee replacement: a meta-analysis. J Bone Joint Surg Am. 2007;89:261–269.PubMedCrossRefGoogle Scholar
  5. 5.
    Beaule PE, Dorey FJ, LeDuff M, Gruen T, Amstutz HC. Risk factors affecting outcome of metal-on-metal surface arthroplasty of the hip. Clin Orthop Relat Res. 2004;418:87–93.PubMedCrossRefGoogle Scholar
  6. 6.
    Beaule PE, Lee JL, Le Duff MJ, Amstutz HC, Ebramzadeh E. Orientation of the femoral component in surface arthroplasty of the hip: a biomechanical and clinical analysis. J Bone Joint Surg Am. 2004;86:2015–2021.PubMedGoogle Scholar
  7. 7.
    Belei P, Skwara A, De La Fuente M, Schkommodau E, Fuchs S, Wirtz DC, Kamper C, Radermacher K. Fluoroscopic navigation system for hip surface replacement. Comput Aided Surg. 2007;12:160–167.PubMedCrossRefGoogle Scholar
  8. 8.
    Bell RS, Schatzker J, Fornasier VL, Goodman SB. A study of implant failure in the Wagner resurfacing arthroplasty. J Bone Joint Surg Am. 1985;67:1165–1175.PubMedGoogle Scholar
  9. 9.
    Beringer DC, Patel JJ, Bozic KJ. An overview of economic issues in computer-assisted total joint arthroplasty. Clin Orthop Relat Res. 2007;463:26–30.PubMedGoogle Scholar
  10. 10.
    Bolognesi M, Hofmann A. Computer navigation versus standard instrumentation for TKA: a single-surgeon experience. Clin Orthop Relat Res. 2005;440:162–169.PubMedCrossRefGoogle Scholar
  11. 11.
    Boyd HS, Ulrich SD, Seyler TM, Marulanda GA, Mont MA. Resurfacing for Perthes disease: an alternative to standard hip arthroplasty. Clin Orthop Relat Res. 2007;465:80–85.PubMedGoogle Scholar
  12. 12.
    Chin PL, Yang KY, Yeo SJ, Lo NN. Randomized control trial comparing radiographic total knee arthroplasty implant placement using computer navigation versus conventional technique. J Arthroplasty. 2005;20:618–626.PubMedCrossRefGoogle Scholar
  13. 13.
    Cobb JP, Kannan V, Brust K, Thevendran G. Navigation reduces the learning curve in resurfacing total hip arthroplasty. Clin Orthop Relat Res. 2007;463:90–97.PubMedGoogle Scholar
  14. 14.
    Davis ET, Gallie P, Macgroarty K, Waddell JP, Schemitsch E. The accuracy of image-free computer navigation in the placement of the femoral component of the Birmingham Hip Resurfacing: a cadaver study. J Bone Joint Surg Br. 2007;89:557–560.PubMedCrossRefGoogle Scholar
  15. 15.
    Freeman MA. Some anatomical and mechanical considerations relevant to the surface replacement of the femoral head. Clin Orthop Relat Res. 1978;134:19–24.PubMedGoogle Scholar
  16. 16.
    Haaker RG, Stockheim M, Kamp M, Proff G, Breitenfelder J, Ottersbach A. Computer-assisted navigation increases precision of component placement in total knee arthroplasty. Clin Orthop Relat Res. 2005;433:152–159.PubMedCrossRefGoogle Scholar
  17. 17.
    Hess T, Gampe T, Kottgen C, Szawlowski B. [Intraoperative navigation for hip resurfacing: methods and first results][in German]. Orthopade. 2004;33:1183–1193.PubMedCrossRefGoogle Scholar
  18. 18.
    Howie DW, Campbell D, McGee M, Cornish BL. Wagner resurfacing hip arthroplasty: the results of one hundred consecutive arthroplasties after eight to ten years. J Bone Joint Surg Am. 1990;72:708–714.PubMedGoogle Scholar
  19. 19.
    Howie DW, Cornish BL, Vernon-Roberts B. Resurfacing hip arthroplasty: classification of loosening and the role of prosthesis wear particles. Clin Orthop Relat Res. 1990;255:144–159.PubMedGoogle Scholar
  20. 20.
    Kruger S, Zambelli PY, Leyvraz PF, Jolles BM. Computer-assisted placement technique in hip resurfacing arthroplasty: improvement in accuracy? Int Orthop. Aug 24 2007 [Epub ahead of print].Google Scholar
  21. 21.
    Picard F, Deakin AH, Clarke JV, Dillon JM, Gregori A. Using navigation intraoperative measurements narrows range of outcomes in TKA. Clin Orthop Relat Res. 2007;463:50–57.PubMedGoogle Scholar
  22. 22.
    Ritter MA, Gioe TJ. Conventional versus resurfacing total hip arthroplasty: a long-term prospective study of concomitant bilateral implantation of prostheses. J Bone Joint Surg Am. 1986;68:216–225.PubMedGoogle Scholar
  23. 23.
    Shimmin AJ, Back D. Femoral neck fractures following Birmingham hip resurfacing: a national review of 50 cases. J Bone Joint Surg Br. 2005;87:463–464.PubMedCrossRefGoogle Scholar
  24. 24.
    Vendittoli PA, Lavigne M, Roy AG, Girard J. Removal of acetabular bone in resurfacing arthroplasty of the hip. J Bone Joint Surg Br. 2006;88:838–839.PubMedCrossRefGoogle Scholar
  25. 25.
    Victor J, Hoste D. Image-based computer-assisted total knee arthroplasty leads to lower variability in coronal alignment. Clin Orthop Relat Res. 2004;428:131–139.PubMedCrossRefGoogle Scholar
  26. 26.
    Wirth CJ, Gosse F. Improved implantation technique for resurfacing arthroplasty of the hip. Oper Orthop Traumatol. 2006;18:214–224.PubMedCrossRefGoogle Scholar

Copyright information

© The Association of Bone and Joint Surgeons 2008

Authors and Affiliations

  • Muthu Ganapathi
    • 1
  • Pascal-André Vendittoli
    • 2
  • Martin Lavigne
    • 2
  • Klaus-Peter Günther
    • 3
  1. 1.Maisonneuve-Rosemont HospitalMontrealCanada
  2. 2.Department of SurgeryMontreal University, Maisonneuve-Rosemont HospitalMontrealCanada
  3. 3.Department of OrthopaedicsDresden UniversityDresdenGermany

Personalised recommendations