Navigation of acetabular component orientation is still not commonly performed despite repeated studies that show that more than ½ of acetabular components placed during hip arthroplasty are significantly mal-positioned and that intra-operative radiographic assessment is unreliable. The current study uses postoperative CT to assess the accuracy of a smart mechanical navigation instrument system for cup alignment. Thirty seven hip replacements performed using a smart mechanical navigation device (the HipXpert System) had post-operative CT studies available for analysis. These post-operative CT studies were performed for pre- operative planning of the contralateral side, one to three years following the prior surgery. An application specific software module was developed to measure cup orientation using CT (HipXpert Research Application, Surgical Planning Associates Inc., Boston, Massachusetts). The method involves creation of a 3D surface model from the CT data and then determination of an Anterior Pelvic Plane coordinate system. A multiplaner image viewer module is then used to create an image through the CT dataset that is coincident with the opening plane of the acetabular component. Points in this plane are input and then the orientation of the cup is calculated relative to the AP Plane coordinate space according to Murray's definitions of operative anteversion and operative inclination. The actual cup orientation was then compared to the goal of cup orientation recorded when the surgery was performed using the system for acetabular component alignment.Introduction
Patients and Methods
Navigation of acetabular component orientation is still not commonly performed despite repeated studies that show that more than ½ of acetabular components placed during hip arthroplasty are significantly malpositioned1. The current study uses postoperative CT to assess the accuracy of a smart mechanical navigation instrument system for cup alignment. Thirty seven hip replacements performed using a smart mechanical navigation device (the HipXpert System) had post-operative CT studies available for analysis. These post-operative CT studies were performed for pre-operative planning of the contralateral side, one to three years following the prior surgery. An application specific software module was developed to measure cup orientation using CT (HipXpert Research Application, Surgical Planning Associates Inc., Boston, Massachusetts). The method involves creation of a 3D surface model from the CT data and then determination of an Anterior Pelvic Plane coordinate system. A multiplaner image viewer module is then used to create an image through the CT dataset that is coincident with the opening plane of the acetabular component. Points in this plane are input and then the orientation of the cup is calculated relative to the AP Plane coordinate space according to Murray's definitions of operative anteversion and operative inclination. The actual cup orientation was then compared to the goal of cup orientation recorded when the surgery was performed using the system for acetabular component alignment.Introduction
Patients and Methods
Navigation of acetabular component orientation is still not commonly performed despite repeated studies that show that more than ½ of acetabular components placed during hip arthroplasty are significantly malpositioned1. The current study uses postoperative CT to assess the accuracy of a smart mechanical navigation instrument system for cup alignment. Twenty nine hip replacements performed using the HipXpert Navigation System had post-operative CT studies available for analysis. These post-operative CT studies were performed for pre-operative planning of the contralateral side, one to three years following the prior surgery. The patients included 17 men and 11 women. An application specific software module was developed to measure cup orientation using CT (HXR Application 1.3 Surgical Planning Associates Inc., Boston, Massachusetts). The method involves creation of a 3D surface model from the CT data and then determination of an Anterior Pelvic Plane coordinate system. A multiplaner image viewer module is then used to create an image through the CT dataset that is coincident with the opening plane of the acetabular component. Points on this plane are input and then the orientation of the cup is calculated relative to the AP Plane coordinate space according to Murray's definitions of operative anteversion and operative inclination. The actual cup orientation was then compared to the goal of cup orientation recorded when the surgery was performed using the HipXpert navigation system for acetabular component alignment.Introduction
Patients and Methods
