Abstract
Objectives
Many reports were shown about the angle of the cup in total hip arthroplasty (THA) with CT-based navigation system. However, there are few reports about the position of the stem. We investigated the position of the stem in navigated THA. We evaluated the position and alignment of stem which were shown on intra-operative navigation system.
Materials and Methods
We treated 10 hips in 10 patients (1 male and 9 females) by navigated THA. 7 osteoarthritis hips and 3 idiopathic osteonecrosis hips were performed THA with VectorVision Hip 2.5.1 navigation system (BrainLAB). Implants were AMS HA cups and PerFix stems (Japan Medical Materials, Osaka). The positions of stem were decided on the 3D model of femur before operation. According to the preoperative planning, we put the implants with navigation system and recorded the position. We measured the position and alignment of stem with 3D template software after operation. We checked for complications.
Results
The average error of stem alignment was 0.9 degrees in anteroposterior direction, 1.2 degrees in mediolateral direction and 3.5 degrees in rotation. The average error of the distance between the tip of greater trochanter and the shoulder of stem was 1.6mm on postoperative CT. Though there were no infections and fractures, 7 cases had postoperative pain on the lesion where we insert tracker pin.
Conclusions
The accuracy of longitudinal stem alignment was correct but the anteversion varies widely. We usually perform THA by minimally invasive technique. Therefore the reference points of proximal femur were restricted at narrow area for registration and the landmarks for deciding the rotational alignment were difficult to be picked up correctly.
