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Computer-assisted placement technique in hip resurfacing arthroplasty: improvement in accuracy?

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Abstract

Freehand positioning of the femoral drill guide is difficult during hip resurfacing and the surgeon is often unsure of the implant position achieved peroperatively. The purpose of this study was to find out whether, by using a navigation system, acetabular and femoral component positioning could be made easier and more precise. Eighteen patients operated on by the same surgeon were matched by sex, age, BMI, diagnosis and ASA score (nine patients with computer assistance, nine with the regular ancillary). Pre-operative planning was done on standard AP and axial radiographs with CT scan views for the computer-assisted operations. The final position of implants was evaluated by the same radiographs for all patients. The follow-up was at least 1 year. No difference between both groups in terms of femoral component position was observed (p > 0.05). There was also no difference in femoral notching. A trend for a better cup position was observed for the navigated hips, especially for cup anteversion. There was no additional operating time for the navigated hips. Hip navigation for resurfacing surgery may allow improved visualisation and hip implant positioning, but its advantage probably will be more obvious with mini-incisions than with regular incision surgery.

Résumé

La position du guide fémoral lors du resurfaçage de hanche peut être améliorée par l’utilisation d’un système de navigation. 18 patients comparables en termes de sexe, d’âge, de BMI, de diagnostic et de score ASA ont été opérés par le même chirurgien. 9 patients ont été traités avec l’aide d’un système de navigation et 9 avec le matériel ancillaire habituel sans navigation. L’analyse pré-opératoire et post-opératoire a consisté en une radiographie face profil et un scanner. Le suivi n’a pas été inférieur à un an. Il n’existe pas de différence entre les deux groupes en terme de position fémorale (p > 0.05), il n’y a pas non plus de différence sur les incisions. Par contre, une meilleure position de la cupule a été observée sur les hanches naviguées surtout pour l’anteversion. Il n’y a pas eu d’augmentation du temps opératoire du fait de la navigation. En conclusion, la navigation de la hanche lors d’une intervention chirurgicale de type resurfaçage permet d’avoir une meilleure visualisation de la position des implants mais ces avantages sont plus importants lors d’une mini incision que lors d’une incision classique.

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Acknowledgments

We thank our data manager Mr Heinrich Ariss.

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Authors and Affiliations

  1. Hôpital Orthopédique de la Suisse Romande, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland

    S. Krüger, P. Y. Zambelli, P.-F. Leyvraz & B. M. Jolles

  2. Hôpital Orthopédique de la Suisse Romande, 4, Avenue Pierre Decker, 1005, Lausanne, Switzerland

    B. M. Jolles

Authors
  1. S. Krüger
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  2. P. Y. Zambelli
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  3. P.-F. Leyvraz
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  4. B. M. Jolles
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Corresponding author

Correspondence to B. M. Jolles.

Additional information

The following authors have designed the study (SK, BMJ), gathered the data (SK, PYZ), analysed the data (SK, PYZ, PFL, BMJ), wrote the initial drafts (SK,BMJ) and ensured the accuracy of the data and analysis (SK, PYZ, PFL, BMJ).

No benefits or funds were received in support of this work. No conflicts of interest are known.

Ethics committee approval was obtained before the beginning of the study.

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Krüger, S., Zambelli, P.Y., Leyvraz, PF. et al. Computer-assisted placement technique in hip resurfacing arthroplasty: improvement in accuracy?. International Orthopaedics (SICO 33, 27–33 (2009). https://doi.org/10.1007/s00264-007-0440-8

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