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A hybrid CT-free navigation system for total hip arthroplasty
Guoyan Zheng1, Axel Marx, Ulrich Langlotz
1Maurice E. Müller Institute for Biomechanics, University of Bern, Bern, Switzerland. Guoyan.Zheng@memot.unibe.ch
Summary
A new CT-free surgical navigation system improves total hip arthroplasty (THA) accuracy. This hybrid system precisely guides acetabular and femoral component placement, enhancing surgical outcomes.
Area of Science:
- Orthopedic Surgery
- Medical Imaging
- Surgical Navigation
Background:
- Total hip arthroplasty (THA) traditionally relies on computed tomography (CT) for component placement.
- CT scans involve radiation exposure and additional costs.
- Novel navigation systems are needed to improve precision and reduce reliance on CT.
Purpose of the Study:
- To develop and assess a novel CT-free image-guided navigation system for THA.
- To assist in the accurate placement of both acetabular and femoral components.
- To evaluate the system's precision and clinical applicability.
Main Methods:
- A hybrid approach combining percutaneous digitization and bi-planar fluoroscopy for landmark acquisition.
- Definition of patient-specific reference coordinate systems for pelvis and femur.
- Real-time computation of key surgical parameters and visualization of instrument actions.
Main Results:
- Laboratory studies demonstrated high precision in measuring femoral stem parameters (antetorsion, varus/valgus, leg length, lateralization).
- Mean deviations from CT-based measurements were minimal (e.g., 1.0° for antetorsion, 0.7 mm for leg length).
- Pilot clinical evaluation indicated significant benefits of the CT-free hybrid system for THA.
Conclusions:
- The developed CT-free hybrid navigation system offers a promising alternative for THA.
- It has the potential to increase accuracy and reliability in total hip arthroplasty.
- This technology may reduce radiation exposure and improve patient outcomes.