Accuracy of Cup Positioning With the Computed Tomography-Based Two-dimensional to Three-Dimensional Matched...

Area of Science:

• Orthopedic Surgery
• Medical Imaging
• Surgical Navigation

Background:

• Limited data exists on the accuracy of cup orientation using computed tomography (CT)-based 2D-3D matched navigation in total hip arthroplasty.
• Previous studies have focused on various navigation systems but not specifically on CT-based 2D-3D matching for cup positioning.

Purpose of the Study:

• To compare the accuracy of cup orientation between CT-based 2D-3D matched navigation and paired-point matched navigation in total hip arthroplasty.
• To evaluate the influence of patient-specific factors on cup orientation accuracy within each navigation group.

Main Methods:

• A prospective, randomized controlled study involving 80 hips (44 with developmental dysplasia of the hips).
• Hips were divided into a CT-based 2D-3D matched navigation group and a paired-point matched navigation group.
• Accuracy of cup orientation was measured by comparing intraoperative records with postoperative measurements; logistic regression analyzed patient factors.

Main Results:

• The CT-based 2D-3D group demonstrated significantly higher accuracy for both cup inclination (2.5° ± 2.2° vs. 4.6° ± 3.3°) and anteversion (2.3° ± 1.7° vs. 4.4° ± 3.3°) compared to the paired-point matched navigation group (P < .0016 and P < .0009, respectively).
• In the paired-point matched navigation group, roof osteophytes and pelvic tilt negatively impacted accuracy.
• Patient factors did not affect cup orientation accuracy in the CT-based 2D-3D matched navigation group.

Conclusions:

• CT-based 2D-3D matched navigation offers superior accuracy for cup positioning in total hip arthroplasty compared to paired-point matched navigation.
• The accuracy of CT-based 2D-3D matched navigation is not influenced by patient-specific factors, making it suitable for complex cases, including developmental dysplasia of the hips.