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General Orthopaedics

The Evaluation of Cup Position in Minimally Invasive Total Hip Arthroplasty by Modified Watson-Jones Approach With CT-Based Navigation System

International Society for Technology in Arthroplasty (ISTA)



Abstract

Objectives

The setting angle of the cup is important for achieving the stability and avoiding the dislocation after total hip arthroplasty (THA). It is difficult to set the cup at correct angle in minimally invasive THA by modified Watson-Jones approach. So we use CT-based navigation system. We evaluated the accuracy of with post-operative CT data.

Materials and Methods

We treated 30 hips in 30 patients (7 male and 23 females) by navigated THA. 26 osteoarthritis hips, 2 rheumatoid arthritis hips and 2 idiopathic osteonecrosis hips were performed THA with VectorVision Hip 3.5.2 navigation system (BrainLAB). Implants were AMS HA cups and PerFix stems (Kyocera Medical, Osaka). Appropriate angles and positions of cups were decided on the 3D model of hip joint before operation. According to the preoperative planning, we put the cups with navigation system and stems without navigation system. We measured the anteversion angle with post-operative CT data and 3-dimensional template software.

Results

The average angle of cup inclination was 35.2 degrees on navigation system in operation. The average angle was 37.4 degrees in post-operative CT data. We calculated the deference between the inclination angle of intra-operative navigation data and the angle of post-operative CT data. The average of error was 2.2 degrees. The average angle of cup anteversion was 24.2 degrees on navigation system in operation. The average angle was 27.5 degrees in post-operative CT data. The average of error was 3.5 degrees.

Conclusions

There are some reports of complications in minimally invasive THA by modified Watson-Jones approach. Anteversion angle of cup are tend to insert from relative anterior direction with this approach. We could make the error of cup setting minimize with CT-based navigation system.


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