Femoral component positioning in hip resurfacing with and without navigation

Early failures after hip resurfacing often are the result of technical errors in placing the femoral component. We asked whether image-free computer navigation decreased the number of outliers compared with the conventional nonnavigated technique. We retrospectively compared 51 consecutive hip resurfacings performed using image-free computer navigation with 88 consecutive hip resurfacings performed without navigation. Patient demographics were similar. There were no differences in the average native femoral neck-shaft angles, planned stem-shaft angles, or postoperative stem-shaft angles. However, when the postoperative stem-shaft angle was compared with the planned stem-shaft angle, there were 33 patients (38%) in the nonnavigated group with a deviation greater than 5 degrees in contrast to none in the navigated group. Notching was present in four patients in the nonnavigated group and none in the navigated group. The average operative time was 111 minutes for the navigated group and 105 minutes for the nonnavigated group. Image-free navigation decreased the number of patients with potentially undesirable implant placements.

Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.