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Accuracy and Reliability of Software Navigation for Acetabular Component Placement in THA: An In Vitro Validation
Alex W Brady1, Jakub Tatka2, Lorenzo Fagotti2
1Steadman Philippon Research Institute, Vail, CO 81657, USA.
Medicina (Kaunas, Lithuania)
|May 28, 2022
Summary
This study validates a new method using 2D fluoroscopy to accurately calculate 3D acetabular cup orientation, improving total hip arthroplasty accuracy. The technique precisely determines inclination and anteversion angles, crucial for successful component placement.
Area of Science:
- Orthopedic Surgery
- Medical Imaging
- Biomechanical Engineering
Background:
- Intraoperative fluoroscopy aids acetabular component positioning in total hip arthroplasty.
- Assessing 3D cup orientation (inclination and anteversion) from 2D fluoroscopy is challenging.
Purpose of the Study:
- To validate a novel method for calculating the 3D orientation of the acetabular cup using 2D fluoroscopic images.
Main Methods:
- A radio-opaque pelvis model with an implanted acetabular cup in nine positions was used.
- 3D orientation was determined using a coordinate measurement machine (CMM) and a novel mathematical formula applied to AP radiographic images.
- Interrater and intrarater reliability of the 2D method were assessed.
Main Results:
- The novel 2D method demonstrated excellent interrater and intrarater reliability for both anteversion and inclination angles (ICCs > 0.988).
- High accuracy was found when comparing the 2D method to the CMM (ICCs > 0.986).
- The Bland-Altman analysis showed a mean error between 2 to 5 degrees.
Conclusions:
- The validated methodology accurately calculates 3D acetabular cup anteversion and inclination from 2D fluoroscopic images within a 5-degree margin.
- This technique can enhance intraoperative acetabular component placement and postoperative assessment in total hip arthroplasty.
