Acetabular component navigation in lateral decubitus based on EOS imaging: A preliminary study of 13 cases

Area of Science:

• Orthopedic Surgery
• Medical Imaging
• Surgical Navigation

Background:

• Acetabular component navigation typically relies on palpating anterior pelvic plane (APP) landmarks, which can be unreliable in the lateral decubitus position.
• Classical navigation requires accurate identification of the anterior superior iliac spine (ASIS) and pubis for APP definition.

Purpose of the Study:

• To evaluate the clinical feasibility of NAVEOS navigation, which uses EOS imaging, in the lateral decubitus position.
• To compare the precision of NAVEOS navigation against traditional APP-based navigation (NAVAPP).

Main Methods:

• A prospective study involved 13 total hip replacements in the lateral decubitus position using NAVAPP.
• NAVEOS landmarks (acetabular center, ASIS, PSIS) were palpated intraoperatively.
• Postoperative EOS imaging (SterEOS3D) was used to measure cup inclination and anteversion, comparing NAVAPP and NAVEOS results.

Main Results:

• Ten patients completed the study after three exclusions.
• Cup inclination differences were 4° (NAVAPP vs. SterEOS3D) and 5° (NAVEOS vs. SterEOS3D).
• Cup anteversion differences were 4.5° (NAVAPP vs. SterEOS3D) and 4° (NAVEOS vs. SterEOS3D).

Conclusions:

• NAVEOS navigation demonstrated comparable precision to classical APP-based navigation.
• NAVEOS simplifies initial landmark acquisition for acetabular component navigation in the lateral decubitus position.
• Further validation with a larger patient cohort is recommended.