Comparison of total hip replacements cup orientation and position using different navigation systems and the conventional manual technique

Background. Aim of this in-vitro study was to compare the hip cup placement for total hip replacement when using different navigation systems compared with the traditional, non-navigated technique. Methods. Five different navigation systems were used: the CT-less systems Navitrack™, Orthopilot™ and Surgetics Station™, as well as the CT-based Navitrack™ and VectorVision™. Three different surgeons carried out five cup implantations using all navigation systems and the manual approach on a surgery dummy. Cup orientation (inclination and anteversion) and the cup position (achieved cup center) were determined with a coordinate measuring machine. Results. In the manual group the variability of the cup orientation was higher in comparison and hardly influenced by the surgeon. Navigation was identified as a significant factor for smaller deviations from planned inclination and anteversion angles (p<0,001 for both). Cup position was not affected by surgeon in the manual group (p=0,966). Compared with manual technique, the cup misplacement vector was significantly smaller in the CT-Navitrack group (p<0,001) but higher in the Navitrack (CT-less) and VectorVision group (p<0,001). Conclusions. The use of computer navigation will help the surgeon to orientate the acetabular component more accurately but not necessarily with regard to cup positioning.

Subjects

Cup positioning

Endoprothesis

Navigation systems

Total hip replacement

DDC Class

610: Medicine, Health

620: Engineering

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Comparison of total hip replacements cup orientation and position using different navigation systems and the conventional manual technique