Computer-assisted surgery prevents complications during peri-acetabular osteotomy

periacetabular-osteotomy-preoperative

Computer-assisted surgery prevents complications during peri-acetabular osteotomy, Hayashi, S., Hashimoto, S., Matsumoto, T. et al. International Orthopaedics (SICOT) (2018).

Abstract:

Purpose
The aim of study is to evaluate the accuracy of a navigation system during curved peri-acetabular osteotomy (CPO).

Methods
Forty-seven patients (53 hips) with hip dysplasia were enrolled and underwent CPO with or without navigation during surgery. Clinical and radiographical evaluations were performed and compared between the navigation group and non-navigation group, post-operatively.

Results
The clinical outcomes were not significantly different between the navigation and non-navigation groups. Furthermore, post-operative reorientation of the acetabular fragment was similar between the navigation and non-navigation groups. However, the discrepancy between the pre-operative planning line and post-operative osteotomy line was significantly improved in the navigation group compared with that in the non-navigation group (p < 0.05). Further, the complication rate was significantly improved in the navigation group (p < 0.001). Conclusion The accuracy of the osteotomy’s position was significantly improved by using the navigation. Therefore, the use of navigation during peri-acetabular osteotomy can avoid complications.

periacetabular-osteotomy-preoperative-planning
The measurement of the distance between the 100-mm radius sphere line that was determined during pre-operative planning and the post-operative iliac bone surface (the error distance) on the a coronal and b axial planes. a The error distance outside the pelvis on the coronal plane (50–45.5 mm= 4.5 mm). b The error of the distance inside the pelvis on the axial plane (57.8–50 mm= 7.8 mm)

New system of computer-assisted navigation leading to reduction in operating time in uncemented total hip replacement

A new system of computer-assisted navigation leading to reduction in operating time in uncemented total hip replacement in a matched population by Chaudhry, Ismail, and Davis, European Journal of Orthopaedic Surgery & Traumatology (2018).

Abstract:

Computer-assisted navigation techniques are used to optimise component placement and alignment in total hip replacement. It has developed in the last 10 years but despite its advantages only 0.3% of all total hip replacements in England and Wales are done using computer navigation. One of the reasons for this is that computer-assisted technology increases operative time. A new method of pelvic registration has been developed without the need to register the anterior pelvic plane (BrainLab hip 6.0) which has shown to improve the accuracy of THR. The purpose of this study was to find out if the new method reduces the operating time. This was a retrospective analysis of comparing operating time in computer navigated primary uncemented total hip replacement using two methods of registration. Group 1 included 128 cases that were performed using BrainLab versions 2.1-5.1. This version relied on the acquisition of the anterior pelvic plane for registration. Group 2 included 128 cases that were performed using the newest navigation software, BrainLab hip 6.0 (registration possible with the patient in the lateral decubitus position). The operating time was 65.79 (40–98) minutes using the old method of registration and was 50.87 (33–74) minutes using the new method of registration. This difference was statistically significant. The body mass index (BMI) was comparable in both groups. The study supports the use of new method of registration in improving the operating time in computer navigated primary uncemented total hip replacements.