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Review
. 2024 Mar 1;36(1):26-36.
doi: 10.5371/hp.2024.36.1.26.

The Value of Computed Tomography Scan in Three-dimensional Planning and Intraoperative Navigation in Primary Total Hip Arthroplasty

Fabio Mancino  1 , Andreas Fontalis  1 , Ahmed Magan  1 , Ricci Plastow  1 , Fares S Haddad  1
Affiliations
Review

The Value of Computed Tomography Scan in Three-dimensional Planning and Intraoperative Navigation in Primary Total Hip Arthroplasty

Fabio Mancino et al. Hip Pelvis. .

Abstract

Total hip arthroplasty (THA) is a frequently performed procedure; the objective is restoration of native hip biomechanics and achieving functional range of motion (ROM) through precise positioning of the prosthetic components. Advanced three-dimensional (3D) imaging and computed tomography (CT)-based navigation are valuable tools in both the preoperative planning and intraoperative execution. The aim of this study is to provide a thorough overview on the applications of CT scans in both the preoperative and intraoperative settings of primary THA. Preoperative planning using CT-based 3D imaging enables greater accuracy in prediction of implant sizes, leading to enhancement of surgical workflow with optimization of implant inventory. Surgeons can perform a more thorough assessment of posterior and anterior acetabular wall coverage, acetabular osteophytes, anatomical landmarks, and thus achieve more functional implant positioning. Intraoperative CT-based navigation can facilitate precise execution of the preoperative plan, to attain optimal positioning of the prosthetic components to avoid impingement. Medial reaming can be minimized preserving native bone stock, which can enable restoration of femoral, acetabular, and combined offsets. In addition, it is associated with greater accuracy in leg length adjustment, a critical factor in patients' postoperative satisfaction. Despite the higher costs and radiation exposure, which currently limits its widespread adoption, it offers many benefits, and the increasing interest in robotic surgery has facilitated its integration into routine practice. Conducting additional research on ultra-low-dose CT scans and examining the potential for translation of 3D imaging into improved clinical outcomes will be necessary to warrant its expanded application.

Keywords: Computed tomography; Patient reported outcomes; Planning techniques; Robotics; Total hip arthroplasty.

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Conflict of interest statement

CONFLICT OF INTEREST

Prof. F.S.H. reports the following: British Orthopaedic Sports Trauma and Arthroscopy Association (board or committee member), British Orthopaedic Association (board or committee member), Corin (IP royalties), Journal of Bone and Joint Surgery – British (editorial or governing board), Matortho (IP royalties), Orthopedics Today (editorial or governing board), Smith & Nephew (IP royalties; paid consultant; research support), Stryker (IP royalties; paid consultant; research support).

No other potential conflict of interest relevant to this article was reported.

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