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. 2020 May 27;9(6):1620.
doi: 10.3390/jcm9061620.

Total Hip Arthroplasty Using Imageless Computer-Assisted Navigation-2-Year Follow-Up of a Prospective Randomized Study

Richard Lass  1 , Boris Olischar  1 , Bernd Kubista  1 , Thomas Waldhoer  2 , Alexander Giurea  1 , Reinhard Windhager  1
Affiliations

Total Hip Arthroplasty Using Imageless Computer-Assisted Navigation-2-Year Follow-Up of a Prospective Randomized Study

Richard Lass et al. J Clin Med. .

Abstract

The purpose of this study is to compare computer-assisted to manual implantation-techniques in total hip arthroplasty (THA) and to find out if the computer-assisted surgery is able to improve the clinical and functional results and reduce the dislocation rate in short-terms after THA. We performed a concise minimum 2-year follow-up of the patient cohort of a prospective randomized study published in 2014 and evaluated if the higher implantation accuracy in the navigated group can be seen as an important determinant of success in total hip arthroplasty. Although a significant difference was found in mean postoperative acetabular component anteversion and in the outliers regarding inclination and anteversion (p < 0.05) between the computer-assisted and the manual-placed group, we could not find significant differences regarding clinical outcome or revision rates at 2-years follow-up. The implantation accuracy in the navigated group can be regarded as an important determinant of success in THA, although no significant differences in clinical outcome could be detected at short-term follow-up. Therefore, further long-term follow-up of our patient group is needed.

Keywords: accuracy assessment; cup placement; mid-term results; navigated total hip arthroplasty; prospective randomized study.

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Conflict of interest statement

On behalf of all authors, the corresponding author states that there is no conflict of interest. Each author certifies that he has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. Each author certifies that his institution has approved the human protocol for this investigation that all investigations were conducted in conformity with ethical principles of research and that informed consent was not required for the study.

Figures

Figure 1
Figure 1
(a). Standard pelvic radiograph after total hip arthroplasty in standing position, the central beam directed at the symphysis. Cup inclination (1) and anteversion (2), rotational center of the hip (3), and leg length (4). (b). A simplified method to determine acetabular cup anteversion from plain radiographs (Widmer KH [23]). The short axis of the projected ellipse is measured and related to the total cross-section of the projected cup along the short axis. This relationship correlates with acetabular cup anteversion angles and represents an inverse sinus function.
Figure 2
Figure 2
Postoperative mean anteversion and inclination (standard deviation) in the manual and navigated group after 24 months.
Figure 3
Figure 3
Distribution of anteversion and inclination angles measured in the postoperative x-ray after 24 months in the navigated and manual group.
See this image and copyright information in PMC

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