NAVIGATED AND NONNAVIGATED TOTAL HIP ARTHROPLASTY: RESULTS OF TWO CONSECUTIVE SERIES ON CUP POSITIONING

Abstract

Navigation technology is a new tool which can help surgeons to a more accurate hip component implantation and a better reproducibility of the procedure.

The purpose of this study was to compare conventional and navigated technique and a new developed straight hip stem for uncemented primary total hip replacement.

The results of two consecutive implantation series of 42 patients (non navigated) and 42 patients (navigated) were analysed for implant positioning and short term complications. Non navigated components were implanted through conventional incision (15 cm), navigated component by minimal invasive surgery (5 cm). All surgeries were performed through Hardinge approach and by a single senior surgeon.

Radiographic analysis of cup position showed a significant improvement with reduced radiological inclination (53° non navigated/44° navigated, p< 0.001) and higher anteversion (7° non navigated/12° navigated, p< 0.001). The mean postoperative limb length difference was 6.2 mm (SD 9.0, non navigated) and 4.4 mm (SD 6.4, navigated). Intraoperative and early postoperative complications were not different. No dislocation occurred in both groups. There was one intraoperative trochanter fracture which was not revised (non navigated) and one revision because of a periprosthetic fracture caused by fall down during rehabilitation (navigated).

We conclude that acetabular implant positioning can be significantly improved by the use of navigated surgery technique even in minimal invasive surgery condition. The data for postoperative limb length difference was still similar but within the expected range in both groups. Navigation technology seems essential for minimal invasive surgical procedure yielding help and security to the surgeon. The effect of improved cup positioning on mid and long term results for both groups have to be further investigated.