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KMID : 1207720210130020144
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Clinics in Orthopedic Surgery
2021 Volume.13 No. 2 p.144 ~ p.151
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Comparison of Cup Setting Angle Accuracy between Computed Tomography-Based and Computed Tomography-Free Navigation in the Same Patients with Crowe's Classification I or II Hip Dysplasia
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Kaku Nobuhiro
Tagomori Hiroaki
Tsumura Hiroshi
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Abstract
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Backgroud: In total hip arthroplasty, the cup setting angle may affect the postoperative results. In recent years, both computed tomography-based navigation and computed tomography-free (imageless) navigation have been reported to produce high accuracy in cup installation; however, no direct comparison between these two methods has been performed. The present study aimed to directly compare the cup installation angle accuracy between computed tomography-based navigation and computed tomography-free navigation in patients with Crowe's classification stage I or II dysplastic osteoarthritis and to examine the factors affecting the cup installation accuracy.
Methods: Using both navigation systems for the same technique, primary total hip arthroplasty was performed by the same surgeon in 36 patients. A cup was installed using computed tomography-based navigation, and the installed cup was measured again using computed tomography-free navigation. We compared the error between the target angle and the intraoperative installation angle for each navigation method by performing statistical analyses.
Results: For computed tomography-based navigation, errors in the inclination and the anteversion angles compared to the target angle were 3.14° ± 1.55° and 1.47° ± 0.99°, respectively. For computed tomography-free navigation, the inclination and anteversion angle errors were significantly larger, i.e., 6.84° ± 4.78° and 5.43° ± 5.22°, respectively (p < 0.01). The inclination and anteversion angles of computed tomography-free navigation were correlated, and there were no significant factors influencing the error.
Conclusions: Computed tomography-based navigation is more accurate for cup installation than computed tomography-free navigation. When using computed tomography-free navigation, it is necessary to add technical schemes before and during surgery to improve the cup installation accuracy.
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KEYWORD
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Hip arthroplasty, Computer-assisted surgery, Computed tomography, Prostheses and implants, Acetabulum
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