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. 2023 Dec 9;58(2):121-126.
doi: 10.1007/s43465-023-01060-9. eCollection 2024 Feb.

Defining the Learning Period of a Novel Imageless Navigation System for Posterior Approach Total Hip Arthroplasty: Analysis of Surgical Time and Accuracy

Christian B Ong  1 , Justin M Ong  1 , Jacqueline Grubel  1 , Yu-Fen Chiu  2 , Ajay Premkumar  1 , Gwo-Chin Lee  1 , Alejandro Gonzalez Della Valle  1
Affiliations

Defining the Learning Period of a Novel Imageless Navigation System for Posterior Approach Total Hip Arthroplasty: Analysis of Surgical Time and Accuracy

Christian B Ong et al. Indian J Orthop. .

Abstract

Introduction: The use of imageless navigation in total hip arthroplasty (THA) is frequently associated with prolonged surgical times, predominantly during the learning period. The purpose of the present study was to characterize the learning period of a novel imageless navigation system, specifically as it related to surgical time and acetabular navigation accuracy.

Materials and methods: This was a retrospective observational study of a consecutive group of 158 patients who underwent primary unilateral THA for osteoarthritis by a team headed by a single surgeon. All procedures used an imageless navigation system to measure acetabular cup inclination and anteversion angles, referencing a generic sagittal and frontal plane. Navigation accuracy was determined by assessing differences between intraoperative inclination and anteversion values and those obtained from standardized 6-week follow-up radiographs. Operative time and navigation accuracy were assessed by plotting moving averages of 7 consecutive cases. The learning period was defined using Mann-Kendall trend analyses, student t-tests and nonlinear regression modeling based on surgical time and navigation accuracy. Alpha error was 0.05.

Results: The average surgical time was 67.3 min (SD:9.2) (range 45-95). The average navigation accuracy for inclination was 0.01° (SD:4.2) (range - 10 to 10), and that for anteversion was - 4.9° (SD:3.8) (range - 14 to 5). Average surgical time and navigation accuracy were similar between the first and final cases in the series with no learning period detected.

Conclusions: There was no discernible learning period effect on surgical time or system measurement accuracy during the early phases of adoption for this imageless navigation system.

Keywords: Accuracy; Computer assisted surgery; Imageless navigation; Learning curve; Total hip arthroplasty.

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Conflict of interest statement

Conflict of interestAuthor A.G.D.V. is a paid consultant for, and owns stock or stock options in Naviswiss.

Figures

Fig. 1
Fig. 1
Plot of 7-case simple moving averages for surgical time
Fig. 2
Fig. 2
Plot of 7-case simple moving averages for Raw inclination accuracy
Fig. 3
Fig. 3
Plot of 7-case simple moving averages for Raw anteversion accuracy
See this image and copyright information in PMC

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