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Acetabular positioning is more consistent with the use of a novel miniature computer-assisted device

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Abstract

Introduction

Computer-assisted surgery (CAS) relying on registration of the anterior pelvic plane (APP) allows precise acetabular component placement. We determined the variability of cup placement in patients who underwent THA with and without the use of CAS that does not rely on the registration of APP.

Methods

Fifty-one patients who underwent staged-bilateral THAs, one without CAS (control), and a subsequent one with CAS (study group), were included. Acetabular inclination and anteversion were measured on standardized post-operative radiographs. Variance in cup position and Lewinnek’s zone proportionality were compared between the groups. Multiple regressions were performed to identify factors affecting variability in acetabular component placement.

Results

The mean inclination for the control and study group was 42.7° (SD 4.5) and 42.5° (SD 2.9), respectively. The inclination variance was 20.5° and 8.2° respectively (p = < 0.001). Cup inclination was more consistent in the study than in the control group (deviation from the mean: 2.3° vs. 3.8°, p < 0.001). The mean anteversion for the control and the study group was 25.5° (SD 7.4) and 26.8° (SD 4.3), respectively. The anteversion variance was 54.2° and 18.2° respectively (p = <0.001). Consistency in cup anteversion was significantly improved with CAS (deviation from the mean: 3.4° vs. 5.8°; p = 0.002). Lewinnek’s zone proportionality was not affected by the use of  CAS. In the linear regression analysis, CAS significantly increased consistency in cup inclination (p = 0.01). Patient’s factors including BMI and laterality affected consistency of cup placement.

Conclusion

CAS without referencing the APP allows a more consistent orientation of the acetabular component when compared to freehand placement.

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Acknowledgments

This study was possible due to the generous contribution of Intellijoint Surgical, Mr. Glenn Bergenfield, and The Sidney Milton and the Leoma Simon Foundation (Florida).

Funding

Funding for this study was provided by Intellijoint Surgical Inc. and the generous contribution of the Sidney Milton and Leoma Simon Foundation (Florida).

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA

    Ivan Jacob, Kate Shanaghan & Alejandro Gonzalez Della Valle

  2. Intellijoint Surgical Inc., Waterloo, ON, Canada

    Jessica Benson

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  1. Ivan Jacob
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  2. Jessica Benson
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  4. Alejandro Gonzalez Della Valle
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Correspondence to Alejandro Gonzalez Della Valle.

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Jacob, I., Benson, J., Shanaghan, K. et al. Acetabular positioning is more consistent with the use of a novel miniature computer-assisted device. International Orthopaedics (SICOT) 44, 429–435 (2020). https://doi.org/10.1007/s00264-020-04484-2

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