Isolated acetabular revision with femoral stem retention using computed tomography-based navigation

Area of Science:

• Orthopedic Surgery
• Medical Navigation Systems
• Total Hip Arthroplasty

Background:

• Accurate acetabular cup placement is crucial in revision surgery to prevent dislocation.
• Existing literature lacks data on combined cup and stem anteversion and dislocation rates in isolated acetabular revision.
• Comparison between navigated and manual implantation techniques for acetabular revision is needed.

Purpose of the Study:

• To evaluate the accuracy of combined anteversion in isolated acetabular revision using computed tomography-based navigation.
• To compare the accuracy of cup angle and combined anteversion between navigated and manual techniques.
• To assess the impact of navigation on dislocation rates and operative time in acetabular revision surgery.

Main Methods:

• Retrospective comparative study of 32 hips (navigation group) versus 8 hips (control group).
• All patients underwent isolated acetabular revision total hip arthroplasty.
• Computed tomography-based navigation system used in the study group; manual implantation in the control group.

Main Results:

• The navigation group achieved an average Widmer's combined anteversion of 39.0°±8.7°, closer to the target than the control group (47.2°±15.1°).
• Errors in combined anteversion measurement were smaller in the navigation group (7.2°±5.1°) compared to the control group (13.9°±11.1°).
• No dislocations occurred in the navigation group (0%) versus one in the control group (12.5%).

Conclusions:

• Computed tomography-based navigation aids in achieving target combined anteversion during isolated acetabular revision.
• Navigation demonstrated improved accuracy in combined anteversion compared to manual implantation.
• Preliminary findings suggest navigation may reduce dislocation rates in acetabular revision surgery.