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General Orthopaedics

Improving Acetabular Cup Placement in Total Hip Replacement Surgery with the Use of Smartphone Technology

The South African Orthopaedic Association (SAOA) 57th Annual Congress



Abstract

Acetabular cup placement in total hip replacement surgery is often difficult to assess, especially in the lateral position and using the posterior approach. On table control X-Rays are not always accessible, especially in the government sector. Conventional techniques and computer assisted surgery (CAS), are currently the two most popular methods for proper placement of the acetabular cup in Lewinnek's safe zone of orientation (anteversion 15°–10° and lateral inclination 40°±10°). We developed a simple way to get accurate cup placement using Smartphone technology.

Methods:

A spirit level application was downloaded to the Smartphone. The acetabulum inclination was measured on the pre-operative X-Rays. The phone is placed in a sterile bag and then used intra-operatively, to measure and set our acetabular cup orientation to our pre-operative measurements. The inclination level was measured before and after final placement of the acetabular cup. This was compared to the acetabular cup inclination in our post-operative X-Rays.

Results:

In our series of 50 cup placements we found high accuracy. The results show less than 5° deviation between our pre-, intra- and post-operative measurements.

Conclusions:

Smartphone technology proves to be good alternative to conventional methods and CAS, to improve Acetabular Cup placement in Total Hip Arthroplasty.