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Greater accuracy in positioning of the acetabular cup by using an image-free navigation system

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Abstract

In a prospective and randomised clinical study, acetabular cups were implanted free-hand (control group n=22) or with computer assistance using an image-free navigation system (study group n=23). The cup position was determined postoperatively on pelvic CT. An average inclination of 42.3° (range: 30°–53°; SD±7.0°) and an average anteversion of 24.0° (range: −3° to 51°; SD±15.0°) were found in the control group, and an average inclination of 45.0° (ranage: 40°–50°; SD±2.8°) and an average anteversion of 14.4° (range: 5°–25°; SS±5.0°) in the computer-assisted study group. The deviations from the desired cup position (45° inclination, 15° anteversion) were significantly lower in the computer-assisted study group (p<0.001 each). While only 11/22 of the cups in the control group were within the Lewinnek safe zone, 21/23 of the cups in the study group were placed in this target region (p=0.003).

Résumé

Dans un étude clinique prospective et randomisé, les cupules acétabulaires ont été implantées de façon habituelle (n=22; groupe témoin) ou avec assistance d’un ordinateur qui utilise un système de navigation image—libre (n=23; groupe d’étude). La place de la cupule a été déterminée après l’opération sur un scanner pelvien. Une inclinaison moyenne de 42,3° (30° à 53°; ±7.0°) et une antéversion moyenne de 24,0° (−3° à 51°; ±15.0°) ont été trouvées dans le groupe témoin et une inclinaison moyenne de 45,0° (40° à 50°; ±2.8°) et une antéversion moyenne de 14,4° (5° à 25°; ±5.0°) dans le groupe de l’étude assistée par ordinateur. Les déviations par rapport à la position désirée de la cupule (45° d’inclinaison, 15° d’antéversion) étaient notablement inférieures dans le groupe de l’étude assistée par ordinateur (p<0.001 chacun). Alors que seulement 11 des 22 cupules du groupe témoin étaient dans la zone sûre de Lewinnek, 21 des 23 cupules du groupe d’étude ont été placées dans cette région cible (p=0.003).

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Regensburg, Bad Abbach, Germany

    T. Kalteis, M. Handel, L. Perlick, H. Baethis & J. Grifka

  2. Institute of Radiology, University of Regensburg, Bad Abbach, Germany

    T. Herold

  3. Department of Orthopaedic Surgery, Kaiser-Karl V.-Allee 3, 93077, Bad Abbach, Germany

    T. Kalteis

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  1. T. Kalteis
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  2. M. Handel
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  3. T. Herold
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  4. L. Perlick
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  5. H. Baethis
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  6. J. Grifka
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Correspondence to T. Kalteis.

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Kalteis, T., Handel, M., Herold, T. et al. Greater accuracy in positioning of the acetabular cup by using an image-free navigation system. International Orthopaedics (SICOT) 29, 272–276 (2005). https://doi.org/10.1007/s00264-005-0671-5

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  • DOI: https://doi.org/10.1007/s00264-005-0671-5

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