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Randomized Controlled Trial
. 2024 Dec;16(12):3078-3087.
doi: 10.1111/os.14251. Epub 2024 Sep 29.

Computer-Assisted Total Hip Arthroplasty Improves Acetabular Prosthesis Placement Accuracy: A Multicenter, Randomized Controlled Clinical Study

Ge Zhou  1   2 , Xiao Geng  1   2 , Ming Zhang  3 , Zhiwen Sun  4 , Feng Li  1   2 , Minwei Zhao  1   2 , Hua Tian  1   2
Affiliations
Randomized Controlled Trial

Computer-Assisted Total Hip Arthroplasty Improves Acetabular Prosthesis Placement Accuracy: A Multicenter, Randomized Controlled Clinical Study

Ge Zhou et al. Orthop Surg. 2024 Dec.

Abstract

Objective: The long-term effectiveness of total hip arthroplasty (THA) largely depends on the accuracy of acetabular prosthesis placement. To improve the accuracy of acetabular prosthesis placement, we utilized a new surgical navigation system: visual treatment solution (VTS). The purpose of this study was to verify the efficacy and safety of this system in assisting THA.

Methods: This was a prospective, multicenter, randomized controlled trial. One hundred and twenty-four patients undergoing primary THAs were included. The experimental group underwent VTS-assisted THA, and the control group underwent traditional surgical techniques. The main efficacy evaluation indicators were the proportion of anteversion and inclination angles in the Lewinnek safe zone, and secondary evaluation indicators included operation time, Western Ontario and McMaster University Osteoarthritis index (WOMAC) score, Harris score, short-form-36 (SF-36) score, and hip dislocation rate. Statistical analysis was performed mainly by t-test and chi-square test.

Results: The proportion of both anteversion and inclination angles in the safe zone was 93.1% in the experimental group and 50.9% in the control group; the difference was significant (p < 0.01). The average operation time was 112.5 min in the experimental group and 92.6 min in the control group; the difference was significant (p < 0.01). There were no significant differences in WOMAC score, Harris score, or SF-36 score between the experimental and control groups at 3 months after the operation (p > 0.05). The dislocation rate was 0% in the experimental group and 1.6% in the control group; the difference was not significant (p > 0.05).

Conclusion: VTS-assisted THA can significantly improve the accuracy of acetabular prosthesis placement. However, there were no differences in short-term clinical outcomes or dislocation rates between the two groups.

Keywords: Accuracy; Computer‐Assisted Navigation; Cup Position; Safe Zone; Total Hip Arthroplasty.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
The surgical navigation system for total hip arthroplasty: visual treatment solution (VTS).
FIGURE 2
FIGURE 2
Consolidated Standards of Reporting Trials (CONSORT) diagram. There were 62 patients recruited in each group. Eventually, data from 113 patients (58 in navigation group vs. 55 in conventional group) were collected for statistical analysis.
FIGURE 3
FIGURE 3
Surgical procedures of VTS‐assisted total hip arthroplasty. (A) Preoperative planning; (B) accurate registration; (C) acetabular reaming; (D) cup impaction; (E) cup verification; (F) final results.
FIGURE 4
FIGURE 4
Typical radiographic images for patients. (A) Pre‐operative and (B) post‐operative images of a patient undergoing conventional THA; (C) pre‐operative and (D) post‐operative images of a patient undergoing VTS‐assisted THA.
See this image and copyright information in PMC

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