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Computer-Assisted Total Hip Arthroplasty Improves Acetabular Prosthesis Placement Accuracy: A Multicenter, Randomized

Ge Zhou1,2, Xiao Geng1,2, Ming Zhang3

  • 1Department of Orthopedics, Peking University Third Hospital, Beijing, China.

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|September 30, 2024
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Summary

Visual treatment solution (VTS)-assisted total hip arthroplasty (THA) significantly improves acetabular prosthesis placement accuracy. However, short-term clinical outcomes and dislocation rates showed no significant differences compared to traditional methods.

Keywords:
AccuracyComputer‐Assisted NavigationCup PositionSafe ZoneTotal Hip Arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Medical Technology
  • Surgical Navigation

Background:

  • Accurate acetabular prosthesis placement is crucial for the long-term success of total hip arthroplasty (THA).
  • Traditional surgical techniques may have limitations in achieving optimal implant positioning.
  • Novel navigation systems aim to enhance surgical precision in THA.

Purpose of the Study:

  • To evaluate the efficacy and safety of the visual treatment solution (VTS) navigation system in assisting THA.
  • To compare the accuracy of acetabular component placement using VTS versus conventional methods.
  • To assess the impact of VTS on surgical outcomes and patient-reported measures.

Main Methods:

  • A prospective, multicenter, randomized controlled trial involving 124 patients undergoing primary THA.
  • Patients were randomized to either VTS-assisted THA (experimental group) or traditional surgery (control group).
  • Key outcome measures included the proportion of implants within the Lewinnek safe zone for anteversion and inclination, operation time, and clinical scores (WOMAC, Harris, SF-36), as well as dislocation rates.

Main Results:

  • The VTS group achieved significantly higher accuracy, with 93.1% of implants in the safe zone compared to 50.9% in the control group (p < 0.01).
  • Operation time was longer in the VTS group (112.5 min) versus the control group (92.6 min) (p < 0.01).
  • No significant differences were observed in WOMAC, Harris, or SF-36 scores at 3 months post-operation, nor in the hip dislocation rate between the groups.

Conclusions:

  • VTS-assisted THA demonstrates superior accuracy in acetabular prosthesis placement compared to traditional techniques.
  • Despite improved accuracy, VTS did not lead to significant short-term improvements in clinical outcomes or a reduction in dislocation rates.
  • The VTS system shows potential for enhancing surgical precision in THA, warranting further investigation into its long-term clinical impact.