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Postsurgical infection from using a computed tomography-based hip navigation system during total hip arthroplasty.

Daisuke Inoue1, Tamon Kabata2, Yoshitomo Kajino1

  • 1Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan.

European Journal of Orthopaedic Surgery & Traumatology : Orthopedie Traumatologie
|May 2, 2020
PubMed
Summary

Computed tomography (CT)-based hip navigation for total hip arthroplasty (THA) prolongs surgery but does not increase surgical site infection (SSI) or periprosthetic joint infection (PJI) risk compared to the free-hand technique.

Keywords:
Hip navigation systemPeriprosthetic joint infectionPostoperative surgical site infectionTotal hip arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Medical Technology
  • Infection Control

Background:

  • Computed tomography (CT)-based hip navigation systems enhance implant alignment in total hip arthroplasty (THA).
  • Concerns exist that prolonged operative times associated with navigation may increase infection risks, specifically surgical site infection (SSI) and periprosthetic joint infection (PJI).
  • Limited research compares infection rates between CT-based navigation and the free-hand technique in primary THA.

Purpose of the Study:

  • To evaluate if CT-based hip navigation increases the incidence of SSI and PJI compared to the free-hand technique in primary THA.
  • To assess the safety of CT-based navigation regarding infection complications.

Main Methods:

  • A retrospective study involving 435 primary THAs (366 patients) with a minimum 2-year follow-up.
  • Patients were divided into a non-navigation group (70 hips) and a CT-based navigation group (365 hips).
  • Incidence rates of SSI and PJI were compared between the two groups.

Main Results:

  • Three patients (0.8%) in the navigation group developed SSI or PJI; none occurred in the non-navigation group.
  • No statistically significant difference in SSI or PJI incidence was observed between the navigation and non-navigation groups (P=1.0).
  • The mean operative time was approximately 20 minutes longer in the navigation group.

Conclusions:

  • CT-based hip navigation for primary THA does not appear to be associated with an increased risk of SSI or PJI.
  • Despite a longer operative time, CT-based navigation may be a safe option for achieving precise implant alignment in THA.