Background: Incorrect acetabular component positioning in total hip arthroplasty (THA) has been associated with poor outcomes. Computer-assisted hip arthroplasty increases accuracy and consistency of cup positioning compared to conventional methods. Traditional navigation units have been associated with problems such as bulkiness of equipment and reproducibility of anatomical landmarks, particularly in obese patients or the lateral position. Purpose: We sought to evaluate the accuracy of a novel miniature inertial measurement system, the Navbit Sprint navigation device (Navbit, Sydney, Australia), to navigate acetabular component positioning in both the supine and lateral decubitus positions. We also aimed to validate a new method of patient registration that does not require acquisition of anatomical landmarks for navigation. Methods: We performed THA in a cadaveric study in supine and lateral positions using Navbit navigation to record cup position and compared mean scores from 3 Navbit devices for each cup position on post-implantation CT scans. Results: A total of 11 cups (5 supine and 6 lateral) were available for comparison. A difference of 2.34° in the supine direct anterior approach when assessing acetabular version was deemed to be statistically but not clinically significant. There was no statistically significant difference between CT and navigation measurements of cup position in the lateral position. Conclusion: This cadaveric study suggests that a novel inertial-based navigation tool is accurate for cup positioning in THA in the supine and lateral positions. Furthermore, it validates a novel registration method that does not require the identification of anatomical landmarks.
Australian Orthopaedic Association National Joint Replacement Registry. Australia national joint registry report: 2019. Secondary Australia national joint registry report: 2019. Date unknown. Available at: https://aoanjrr.sahmri.com/annual-reports-2019. Accessed September 25, 2021.
2.
BarrackRLKrempecJAClohisyJC, et al. Accuracy of acetabular component position in hip arthroplasty. J Bone Joint Surg Am. 2013;95(19):1760–1768. https://doi.org/10.2106/JBJS.L.01704.
3.
BlandJMAltmanDG.Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1(8476):307–310.
4.
CallananMCJarrettBBragdonCR, et al. The John Charnley Award: risk factors for cup malpositioning: quality improvement through a joint registry at a tertiary hospital. Clin Orthop Relat Res. 2011;469(2):319–329. https://doi.org/10.1007/s11999-010-1487-1.
5.
CrossMBSchwarzkopfRMillerTTBognerEAMuirJMVigdorchikJM.Improving registration accuracy during total hip arthroplasty: a cadaver study of a new, 3-D mini-optical navigation system. Hip Int. 2018;28(1):33–39. https://doi.org/10.5301/hipint.5000533.
6.
DavisETSchubertMWegnerMHaimerlM.A new method of registration in navigated hip arthroplasty without the need to register the anterior pelvic plane. J Arthroplasty. 2015;30(1):55–60. https://doi.org/10.1016/j.arth.2014.08.026.
7.
FujishiroTHiranakaTHashimotoS, et al. The effect of acetabular and femoral component version on dislocation in primary total hip arthroplasty. Int Orthop. 2016;40(4):697–702. https://doi.org/10.1007/s00264-015-2924-2.
8.
GandhiRMarchieAFarrokhyarFMahomedN.Computer navigation in total hip replacement: a meta-analysis. Int Orthop. 2009;33(3):593–597. https://doi.org/10.1007/s00264-008-0539-6.
9.
GhasemzadeSVJamshidiF.Applications of inertial navigation systems in medical engineering. J Biomed Phys Eng. 2018;8(3):325–332.
GurgelHMCrociATCabritaHAVicenteJRLeonhardtMCRodriguesJC.Acetabular component positioning in total hip arthroplasty with and without a computer-assisted system: a prospective, randomized and controlled study. J Arthroplasty. 2014;29(1):167–171. https://doi.org/10.1016/j.arth.2013.04.017.
12.
HayashiSHashimotoSTakayamaK, et al. Evaluation of the accuracy of acetabular cup orientation using the accelerometer-based portable navigation system. J Orthop Sci. 2020;25(4):612–617. https://doi.org/10.1016/j.jos.2019.09.012.
13.
HohmannEBryantATetsworthK.Anterior pelvic soft tissue thickness influences acetabular cup positioning with imageless navigation. J Arthroplasty. 2012;27(6):945–952. https://doi.org/10.1016/j.arth.2011.09.017.
14.
KamenagaTHayashiSHashimotoS, et al. Accuracy of cup orientation and learning curve of the accelerometer-based portable navigation system for total hip arthroplasty in the supine position. J Orthop Surg (Hong Kong). 2019;27(2):2309499019848871. https://doi.org/10.1177/2309499019848871.
15.
LassRKubistaBOlischarBFrantalSWindhagerRGiureaA.Total hip arthroplasty using imageless computer-assisted hip navigation: a prospective randomized study. J Arthroplasty. 2014;29(4):786–791. https://doi.org/10.1016/j.arth.2013.08.020.
16.
LewinnekGELewisJLTarrRCompereCLZimmermanJR.Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am. 1978;60(2):217–220.
17.
LiYLJiaJWuQNingGZWuQLFengSQ.Evidence-based computer-navigated total hip arthroplasty: an updated analysis of randomized controlled trials. Eur J Orthop Surg Traumatol. 2014;24(4):531–538. https://doi.org/10.1007/s00590-013-1222-1.
18.
MasaokaTYamamotoKShishidoT, et al. Study of hip joint dislocation after total hip arthroplasty. Int Orthop. 2006;30(1):26–30. https://doi.org/10.1007/s00264-005-0032-4.
19.
MatharuGSDanielJZiaeeHMcMinnDJ.Failure of a novel ceramic-on-ceramic hip resurfacing prosthesis. J Arthroplasty. 2015;30(3):416–418. https://doi.org/10.1016/j.arth.2014.10.019XX.
20.
McArthurBAVulcanoECrossMNguyenJDella ValleAGSalvatiE.Acetabular component orientation in total hip arthroplasty: the impact of obesity. Hip Int. 2014;24(3):263–269. https://doi.org/10.5301/hipint.5000125.
21.
MoskalJTCappsSG.Acetabular component positioning in total hip arthroplasty: an evidence-based analysis. J Arthroplasty. 2011;26(8):1432–1437. https://doi.org/10.1016/j.arth.2010.11.011.
OkamotoMKawasakiMOkuraTOchiaiSYokoiH.Comparison of accuracy of cup position using portable navigation versus alignment guide in total hip arthroplasty in supine position. Hip Int. 2021;31:492–499. https://doi.org/10.1177/1120700020908788.
25.
PabingerCLothallerHPortnerNGeisslerA.Projections of hip arthroplasty in OECD countries up to 2050. Hip Int. 2018;28(5):498–506. https://doi.org/10.1177/1120700018757940.
26.
PadgettDEHendrixSLMologneTSPetersonDAHolleyKA.Effectiveness of an acetabular positioning device in primary total hip arthroplasty. HSS J. 2005;1(1):64–67. https://doi.org/10.1007/s11420-005-0109-z.
27.
ParratteSArgensonJN.Validation and usefulness of a computer-assisted cup-positioning system in total hip arthroplasty. A prospective, randomized, controlled study. J Bone Joint Surg Am. 2007;89(3):494–499. https://doi.org/10.2106/JBJS.F.00529.
28.
RibasMCardenasCAstaritaEMoyaEBellottiV.Hip resurfacing arthroplasty: mid-term results in 486 cases and current indication in our institution. Hip Int. 2014;24(suppl 10):S19–S24. https://doi.org/10.5301/hipint.5000172.
29.
RicholtJAEffenbergerHRittmeisterME.How does soft tissue distribution affect anteversion accuracy of the palpation procedure in image-free acetabular cup navigation? An ultrasonographic assessment. Comput Aided Surg. 2005;10(2):87–92. https://doi.org/10.3109/10929080500229447.
30.
Rodriguez de la FlorMHernandez-VaqueroDFernandez-CarreiraJM.Metal presence in hair after metal-on-metal resurfacing arthroplasty. J Orthop Res. 2013;31(12):2025–2031. https://doi.org/10.1002/jor.22450.
31.
SendtnerESchusterTWornerMKalteisTGrifkaJRenkawitzT.Accuracy of acetabular cup placement in computer-assisted, minimally-invasive THR in a lateral decubitus position. Int Orthop. 2011;35(6):809–815. https://doi.org/10.1007/s00264-010-1042-4.
32.
SnijdersTvan GaalenSMde GastA.Precision and accuracy of imageless navigation versus freehand implantation of total hip arthroplasty: a systematic review and meta-analysis. Int J Med Robot. 2017;13(4):1–7. https://doi.org/10.1002/rcs.1843.
33.
SuganoN.Computer-assisted orthopaedic surgery and robotic surgery in total hip arthroplasty. Clin Orthop Surg. 2013;5(1):1–9. https://doi.org/10.4055/cios.2013.5.1.1.
34.
TakadaRJinnoTMiyatakeKHiraoMYoshiiTOkawaA.Portable imageless navigation system and surgeon’s estimate for accurate evaluation of acetabular cup orientation during total hip arthroplasty in supine position. Eur J Orthop Surg Traumatol. 2020;30(4):707–712. https://doi.org/10.1007/s00590-020-02625-2.
35.
TaninoHNishidaYMitsutakeRItoH.Portable accelerometer-based navigation system for cup placement of total hip arthroplasty: a prospective, randomized, controlled study. J Arthroplasty. 2020;35(1):172–177. https://doi.org/10.1016/j.arth.2019.08.044.
36.
TetsunagaTYamadaKTetsunagaT, et al. Comparison of the accuracy of CT- and accelerometer-based navigation systems for cup orientation in total hip arthroplasty. Hip Int. 2021;31(5):603–608. https://doi.org/10.1177/1120700020904940.
37.
VigdorchikJMCrossMBBognerEAMillerTTMuirJMSchwarzkopfR.A cadaver study to evaluate the accuracy of a new 3d mini-optical navigation tool for total hip arthroplasty. Surg Technol Int. 2017;30:447–554.
38.
WanZMalikAJaramazBChaoLDorrLD.Imaging and navigation measurement of acetabular component position in THA. Clin Orthop Relat Res. 2009;467(1):32–42. https://doi.org/10.1007/s11999-008-0597-5.
39.
XuKLiYMZhangHFWangCGXuYQLiZJ.Computer navigation in total hip arthroplasty: a meta-analysis of randomized controlled trials. Int J Surg. 2014;12(5):528–533. https://doi.org/10.1016/j.ijsu.2014.02.014.
40.
YbingerTKumpanWHoffartHEMuschalikBBullmannWZweymullerK.Accuracy of navigation-assisted acetabular component positioning studied by computed tomography measurements: methods and results. J Arthroplasty. 2007;22(6):812–817. https://doi.org/10.1016/j.arth.2006.10.001.
41.
ZizzoGRenL.Position tracking during human walking using an integrated wearable sensing system. Sensors (Basel). 2017;17(12):2866. https://doi.org/10.3390/s17122866.
