Abstract
Introduction
We acquired an optical tracking navigation system for Total Hip Arthroplasty. We compare cup positioning and other operative factors along with clinical results using navigated and non-navigated techniques in a series of 341 Total Hip Arthroplasties.
Method
This is a retrospective review of consecutive patients from November 2005 through December 2010, including 126 cases of imageless computer assisted total hip replacement and 215 cases of standard total hip replacement. We analyzed operative time, blood loss, leg length discrepancy, acetabular component inclination, complications, Harris Hip scores and performed a cost analysis. Follow-up was from 3–64 months. All cases were performed by or under the supervision of a single surgeon. Digital AP pelvic radiographs centered on hips were used for measurements. Radiographic results were averaged based on three individual measurements. Statistics required the student t-Test.
Results
Significant differences (p<0.05) were seen for acetabular inclination (46 degrees vs. 42 degrees), blood loss (380 cc vs. 311 cc), operative time (112 min vs. 62 min) and cost (navigation extra $1973). Significantly more cups were placed in the “safe zone” for inclination in the non-navigated group. No significant differences seen for demographic data, limb length discrepancy, Harris hip scores, blood transfusion rates, and overall complications including dislocation rate. No revisions for aseptic loosening in either group. 5 ASR revisions (n=21) for metallosis /pain.
Conclusions
There was no apparent advantage in using an optical tracking navigation system for total hip replacement. With increased OR time, blood loss, and costs, the system was rather a hindrance. There were no differences in functional outcomes up to 5 years after surgery.
