Hip Pelvis.  2014 Sep;26(3):150-156. 10.5371/hp.2014.26.3.150.

Navigated Acetabular Cup Fixation for Acetabular Deformity or Revision Total Hip Arthroplasty

• Yun HH
• Yoon JR
• Yu JJ
• Seo HS

• KMID: 2054178
• DOI: http://doi.org/10.5371/hp.2014.26.3.150

Abstract

PURPOSE
To evaluate the usefulness of navigated acetabular cup fixation for total hip arthroplasty in patients with acetabular deformity or revision total hip arthroplasty.
MATERIALS AND METHODS
This study enrolled 28 patients with at least 12 months' follow-up. The safe zone of the acetabular cup was defined as 40degrees+/-10degreesin inclination and 15degrees+/-10degreesin anteversion. The authors used the navigation and radiographic data to determine whether the acetabular cup was located within the safe zone or not. To evaluate the clinical outcomes, preoperative and last follow-up Harris hip scores were checked, and the occurrence of complications was evaluated.
RESULTS
According to the navigation data, the mean inclination and anteversion were 38.5degrees+/-4.7degrees(range, 32degrees-50degrees) and 16.6degrees+/-4.0degrees(range, 8degrees-23degrees), respectively. According to the radiographic data the mean inclination and anteversion were 40.5degrees+/-4.6degrees(range, 32degrees-50degrees) and 19.4degrees+/-4.2degrees(range, 8degrees-25degrees), respectively. In both cases, all values were within the safe zone. Harris hip score was improved in all patients from preoperative 52.3+/-14.4 points (range, 29-87 points) to 88.0+/-9.0 points (range, 65-99 points) at the last follow-up. There was no dislocation or loosening of both cases.
CONCLUSION
Navigated acetabular cup fixation is a useful technique for total hip arthroplasty in patients with acetabular deformity or revision total hip arthroplasty because it prevents the malposition and related complications.

Keyword

Hip; Acetabular deformity; Revision; Acetabular cup fixation; Imageless navigation

MeSH Terms

Acetabulum*
Arthroplasty, Replacement, Hip*
Congenital Abnormalities*
Dislocations
Follow-Up Studies
Hip
Humans

Figure

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  Fig. 1 Scatter plot showing navigation anteversion and inclination. The dotted line indicates the safe zone (inclination of 40°±10°and anteversion of 15°±10°).

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  Fig. 2 Scatter plot showing radiographic anteversion and inclination. The dotted line indicates the safe zone (inclination of 40°±10°and anteversion of 15°±10°).

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  Fig. 3 A 62-year-old man with a deformed acetabulum in the right hip. (A) Preoperative anteroposterior hip radiograph. (B) Intraoperative navigation data. The inclination and anteversion values displayed in the fields with gray and white backgrounds are for the initial situation and for final cup implantation, respectively. (C) Anteroposterior hip radiograph at 1-year follow-up. (D) Translateral radiographs of the right hip showing that the components are stable with no evidence of dislocation.

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  Fig. 4 A 81-year-old man with arthritis in the right hip. (A) Preoperative anteroposterior hip radiograph. (B) Anteroposterior hip radiograph after total hip arthroplasty at 1.5-year follow-up, showing that the ceramic liner is broken and cup position is abnormal (inclination: 68°, anteversion: 44°). (C) Anteroposterior hip radiograph after total hip arthroplasty at 1.9-year follow-up, showing that the bubble sign is positive around the hip joint. (D) Intraoperative photo showing extensive metallosis. (E) Intraoperative navigation data. (F) Anteroposterior hip radiographs of the right hip at 1-year follow-up showing that the components are stable with no evidence of dislocation.

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