Evaluating Alternate Registration Planes for Imageless, Computer-Assisted Navigation During Total Hip Arthroplasty

Area of Science:

• Orthopedic Surgery
• Medical Imaging
• Surgical Navigation

Background:

• Imageless computer navigation enhances component placement accuracy in total hip arthroplasty (THA).
• Variations in the registration process can affect the final accuracy of THA procedures.
• Evaluating registration accuracy is crucial for optimizing imageless navigation in THA.

Purpose of the Study:

• To assess the registration accuracy of an imageless navigation device during THA.
• To compare different patient registration planes for accuracy in lateral decubitus positioning.
• To determine the optimal reference plane for accurate acetabular component placement in THA.

Main Methods:

• A prospective observational study involving 94 patients undergoing primary THA with imageless navigation.
• Patient position registered using four planes: coronal, longitudinal, lumbosacral, and hip-shoulder.
• Navigation-derived cup positions compared against postoperative radiographic measurements.

Main Results:

• Inclination measurements using coronal, hip-shoulder, and longitudinal planes showed no significant difference from radiographs.
• Inclination measured via the lumbosacral plane significantly differed from radiographic results (P < .0001).
• Anteversion measurements from the hip-shoulder plane closely matched radiographic findings (P = .50), while other planes showed significant differences.

Conclusions:

• Planes approximating the body's long axis provide accurate intraoperative cup position measurements in THA.
• Registration using the hip-shoulder plane plane yields the most accurate and consistent acetabular component positioning.
• Optimizing registration techniques is key to maximizing the benefits of imageless navigation in THA.