Abstract
Introduction
While component malposition remains a major short and long term problem associated with total hip arthroplasty, enhanced technologies such as navigation and robotics have not yet been widely adopted. Both expense and increased OR time can be obstacles to adoption. The current study assesses the effect of the use of a smart mechanical navigation system on surgery time in total hip arthroplasty.
Patients and Methods
514 consecutive primary total hip arthroplasties were performed by a single surgeon from January 1, 2015 through March 31, 2016. Of these, 40 were performed using a smart mechanical navigation system (the HipXpert System, Surgical Planning Associates Inc., Boston, Massachusetts) and 474 were performed without navigation. The patients were not randomized. Incision to closure time (surgery time) was recorded for each procedure. A two tailed t-test was performed to assess statistical significance.
Results
Mean surgery time for the non-navigated cases was 66 minutes. Mean surgery time for the navigated cases was 70 minutes. The difference in surgery time between the two groups was statistically significant (p=0.003).
Conclusion
Adoption and use of a smart mechanical navigation system has a measurable increase in OR time of 4 minutes. This increase in OR time is quite small and with experience, is likely to further decrease. The amount of surgery time necessary for the use of the system is small compared to traditional navigation systems and especially to robotic systems. The study demonstrates that the adoption of a new smart mechanical navigation system increased surgery time very little. We anticipate that increased experience with the system will allow for the reduction in the need for intraoperative radiographs, which will further decrease surgery time and associated cost while simultaneously improving accuracy.
