Poor usability of computer-assisted navigation for hip fracture surgery

Area of Science:

• Orthopaedic Surgery
• Medical Device Technology
• Surgical Navigation Systems

Background:

• The Stryker ADAPT computer-assisted navigation system offers intraoperative feedback for Gamma3 nail placement.
• The usability of the ADAPT system had not been previously evaluated.
• This study aimed to assess the perceived usability of the ADAPT system in clinical practice.

Purpose of the Study:

• To investigate the perceived usability and user acceptability of the Stryker ADAPT computer-assisted navigation system.
• To evaluate the system's performance in assisting with Gamma3 nail placement for intertrochanteric femur fractures.

Main Methods:

• A descriptive study utilizing prospectively collected data from Aarhus University Hospital.
• Surgeons and nurses received training; ADAPT became mandatory for Gamma3 nail procedures.
• The System Usability Scale (SUS) questionnaire was administered post-procedure to assess perceived usability.

Main Results:

• Fifty procedures were performed by 29 surgeons using ADAPT, with a median first-time SUS score of 43, indicating "poor" usability.
• Experienced surgeons (≥3 procedures) showed no significant improvement in SUS scores over time.
• Positive feedback mentioned K-wire placement assistance and educational value; negative feedback cited inconsistency, slowness, and increased fluoroscopy time.

Conclusions:

• The majority of surgeons rated the usability and acceptability of the ADAPT system as "poor" or "not acceptable".
• Based on these findings, the ADAPT system has not been continued at the institution.
• The System Usability Scale is a viable tool for future research on navigation system usability in orthopaedic surgery.