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The Long-Term Efficacy of Computed Tomography-Navigated Total Hip Arthroplasty: An 18-Year Follow-Up Study
Norio Imai1, Dai Miyasaka2, Shinya Ibuchi3
1Division of Comprehensive Musculoskeletal Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan.
Insights
Computed tomography (CT)-navigated total hip arthroplasty (THA) demonstrates excellent long-term survival rates. This technique shows a low incidence of dislocation and loosening, supporting its use for durable hip replacements.
Area of Science:
- Orthopedic Surgery
- Medical Imaging
- Biomedical Engineering
Background:
- Limited data exists on the long-term outcomes of computed tomography (CT)-navigated total hip arthroplasty (THA).
- CT navigation is hypothesized to reduce complications like dislocation and loosening in THA.
- Assessing long-term survivorship is crucial for evaluating the efficacy of novel surgical techniques.
Purpose of the Study:
- To evaluate the long-term survivorship of CT-navigated THA.
- To determine the incidence of dislocation and loosening after CT-navigated THA.
- To assess the fixation and revision rates in a minimum 15-year follow-up study.
Main Methods:
- Retrospective review of 145 CT-navigated THAs with over 15 years of follow-up.
- Analysis of acetabular and femoral component angles, survivorship, dislocation events, and revision rates.
- Evaluation of acetabular component fixation using plain radiographs.
Main Results:
- Mean follow-up was 18.4 years, with a 99.3% survival rate.
- Only four dislocations (2.8%) occurred, with most early in the follow-up period.
- No cases of acetabular component loosening were identified, indicating stable fixation.
Conclusions:
- CT-navigated THA is associated with excellent long-term survivorship and a low rate of loosening.
- Acceptable component positioning achieved through CT navigation likely contributes to stable initial fixation.
- The findings support CT navigation as a reliable method for improving long-term outcomes in total hip arthroplasty.
Abstract:
Backgroumd: There have been few reports on the long-term survival of computed tomography (CT)-navigated total hip arthroplasty (THA), which should lead to a lower incidence of dislocation and loosening. In this study, we examined survivorship, dislocation, and loosening incidence using plain radiographs over a minimum 15-year follow-up after CT-navigated THA.
Methods:
We retrospectively reviewed 145 consecutive CT-navigated THAs for >15 years. We surveyed the angles placed in both the acetabular and femoral components, survivorship, the occurrence of dislocation, the revision rate, and the fixation grade of the acetabular component.
Results:
The mean follow-up duration was 18.4 years. Overall, 73.8% of THAs were within the safe zone of Lewinnek. There were four dislocations (2.8%), with three occurring within 1 month after surgery and the other within 7 years after surgery. Revision THA was performed in one case (0.69%); consequently, the survival rate was 99.3%. The fixation grade was evaluated in 144 hips, and those were evaluated as having "no loosening".
Conclusions:
CT-navigated THA was speculated to contribute to long-term survivorship, with a low rate of loosening, even after 18 years of follow-up. It was speculated that the acetabular component was placed at an acceptable insertion angle and a suitable position for stable initial fixation.
