Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Apr 9;14(1):8332.
doi: 10.1038/s41598-024-59115-2.

Comparison between accuracy of augmented reality computed tomography-based and portable augmented reality-based navigation systems for cup insertion in total hip arthroplasty

Masahiro Hasegawa  1 , Yohei Naito  2 , Shine Tone  2 , Akihiro Sudo  2
Affiliations

Comparison between accuracy of augmented reality computed tomography-based and portable augmented reality-based navigation systems for cup insertion in total hip arthroplasty

Masahiro Hasegawa et al. Sci Rep. .

Abstract

Augmented reality (AR) has been used for navigation during total hip arthroplasty (THA). AR computed tomography (CT)-based navigation systems and AR-based portable navigation systems that use smartphones can also be used. This study compared the accuracy of cup insertion during THA using AR-CT-based and portable AR-based navigation systems. Patients with symptomatic hip disease who underwent primary THA in the supine position using both AR CT-based and portable AR-based navigation systems simultaneously between October 2021 and July 2023 were included. The primary outcome of this study was the absolute difference between cup angles in the intraoperative navigation record and those measured on postoperative CT. The secondary outcome was to determine the factors affecting the absolute value of the navigation error in radiographic inclination (RI) and radiographic anteversion (RA) of the cup, including sex, age, body mass index, left or right side, approach, and preoperative pelvic tilt. This study included 94 consecutive patients. There were 11 men and 83 women, with a mean age of 68 years. The mean absolute errors of RI were 2.7° ± 2.0° in the AR CT-based and 3.3° ± 2.4° in the portable AR-based navigation system. The mean absolute errors of RA were 2.5° ± 2.1° in the AR CT-based navigation system and 2.3° ± 2.2° in the portable AR-based navigation system. No significant differences were observed in RI or RA of the cup between the two navigation systems (RI: p = 0.706; RA: p = 0.329). No significant factors affected the absolute value of the navigation errors in RI and RA. In conclusion, there were no differences in the accuracy of cup insertion between the AR CT-based and portable AR-based navigation systems.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Augmented reality (AR) markers for computed tomography (CT)-based and portable navigation systems are attached to the two pins inserted into the pelvis.
Figure 2
Figure 2
Photograph of the standard cup holder with the augmented reality (AR) marker.
Figure 3
Figure 3
Screens of the augmented reality (AR) computed tomography (CT)-based navigation system are shown. (A) Surgeons can view a three-dimensional model of the pelvis on the real surgical field on the monitor. Radiographic inclination (RI) and radiographic anteversion (RA) of the cup are provided in real time. (B) Vessel locations can be displayed during surgery.
Figure 4
Figure 4
Cup insertion process using the augmented reality (AR) computed tomography (CT)-based navigation system.
Figure 5
Figure 5
In the portable augmented reality (AR)-based navigation system, the smartphone is attached to the cup impactor. The smartphone recognizes the AR marker attached to the fixation pins at the pelvis. The display of the smartphone shows the radiographic inclination (RI) and radiographic anteversion (RA) of the cup.
Figure 6
Figure 6
Measurement of radiographic inclination (RI) and radiographic anteversion (RA) using the 3-dimensional digital templating system (ZedHip).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Agarwal S, Eckhard L, Walter WL, Peng A, Hatton A, Donnelly B, de Steiger R. The use of computer navigation in total hip arthroplasty is associated with a reduced rate of revision for dislocation: A study of 6,912 navigated THA procedures from the Australian orthopaedic association national joint replacement registry. J. Bone Joint Surg. Am. 2021;103:1900–1905. doi: 10.2106/JBJS.20.00950. - DOI - PubMed
    1. Bohl DD, Nolte MT, Ong K, Lau E, Calkins TE, Della Valle CJ. Computer-assisted navigation is associated with reductions in the rates of dislocation and acetabular component revision following primary total hip arthroplasty. J. Bone Joint Surg. Am. 2019;101:250–256. doi: 10.2106/JBJS.18.00108. - DOI - PubMed
    1. Davis ET, McKinney KD, Kamali A, Kuljaca S, Pagkalos J. Reduced risk of revision with computer-guided versus non-computer-guided THA: An Analysis of manufacturer-specific data from the national joint registry of England, Wales, Northern Ireland and the Isle of Man. JB JS Open Access. 2021;6:e2100006. - PMC - PubMed
    1. Parratte S, Ollivier M, Lunebourg A, Flecher X, Argenson JN. No Benefit after THA performed with computer-assisted cup placement: 10-year results of a randomized controlled study. Clin. Orthop. Relat. Res. 2016;474:2085–2093. doi: 10.1007/s11999-016-4863-7. - DOI - PMC - PubMed
    1. Mentis HM, Chellali A, Manser K, Cao CG, Schwaitzberg SD. A systematic review of the effect of distraction on surgeon performance: Directions for operating room policy and surgical training. Surg. Endosc. 2016;30:1713–1724. doi: 10.1007/s00464-015-4443-z. - DOI - PMC - PubMed