The Addition of Navigation Technology to the Femur-First Approach in Anterior Total Hip Arthroplasty Improves Leg Length Restoration
Background: The addition of computer navigation (CN) technology in direct anterior approach (DAA) total hip arthroplasty (THA) has the potential to improve restoration of hip offset and leg length. In this investigation, we examine the effect of one fluoroscopic-based CN system on biomechanical para...
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Elsevier
2024-12-01
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| Series: | Arthroplasty Today |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344124002620 |
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| author | Stephanie V. Kaszuba, MD Noah Gordon, BS Alex C. Gordon, MD |
| author_facet | Stephanie V. Kaszuba, MD Noah Gordon, BS Alex C. Gordon, MD |
| author_sort | Stephanie V. Kaszuba, MD |
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| description | Background: The addition of computer navigation (CN) technology in direct anterior approach (DAA) total hip arthroplasty (THA) has the potential to improve restoration of hip offset and leg length. In this investigation, we examine the effect of one fluoroscopic-based CN system on biomechanical parameters in DAA THA with femur-first (FF) workflow. Methods: A retrospective review was performed on 235 primary DAA FF THA cases, with 100 CN cases and 135 in the conventional fluoroscopic overlay (FO) group. Radiographic examination was performed. Radiographic outcome measures included differences in hip center position, femoral offset, global offset, and leg length between the THA and native hips. Intraoperative and postoperative complications were also documented. Statistical analysis was performed using a t test for continuous data and a ꭓ2 test for categorical data. Results: While there were differences in individual components of femoral offset and the horizontal hip center, mean difference in global offset was not statistically different between the CN (mean: 2.15 mm) and FO (mean: 1.85 mm) groups (P = .898). The number of outliers was also statistically insignificant. The CN group demonstrated significant improvement in mean leg length discrepancy (mean: 1.52 mm) in comparison to the FO group (mean: 2.26 mm) (P = .001), with 1.09% and 8.89% of outliers, respectively (P = .013). Conclusions: The addition of CN technology to DAA FF THA improved the accuracy and precision of restoring leg length. CN did not significantly affect global offset. There was no significant difference in complications between the CN and FO groups. |
| format | Article |
| id | doaj-art-1e56b74c534d4b1594c4936f25231ba1 |
| institution | Kabale University |
| issn | 2352-3441 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj-art-1e56b74c534d4b1594c4936f25231ba12024-12-19T10:55:27ZengElsevierArthroplasty Today2352-34412024-12-0130101577The Addition of Navigation Technology to the Femur-First Approach in Anterior Total Hip Arthroplasty Improves Leg Length RestorationStephanie V. Kaszuba, MD0Noah Gordon, BS1Alex C. Gordon, MD2Department of Orthopaedic Surgery and Rehabilitation, Yale School of Medicine, New Haven, CT, USA; Corresponding author. Stephanie V. Kaszuba, MD, Yale School of Medicine, Department of Orthopaedics and Rehabilitation, 47 College Street, New Haven, CT 06510, USA. Tel.: +1 203 988 3085.University of Illinois, Urbana-Champaign, IL, USADepartment of Orthopedic Surgery, NorthShore Skokie Hospital, Skokie, IL, USABackground: The addition of computer navigation (CN) technology in direct anterior approach (DAA) total hip arthroplasty (THA) has the potential to improve restoration of hip offset and leg length. In this investigation, we examine the effect of one fluoroscopic-based CN system on biomechanical parameters in DAA THA with femur-first (FF) workflow. Methods: A retrospective review was performed on 235 primary DAA FF THA cases, with 100 CN cases and 135 in the conventional fluoroscopic overlay (FO) group. Radiographic examination was performed. Radiographic outcome measures included differences in hip center position, femoral offset, global offset, and leg length between the THA and native hips. Intraoperative and postoperative complications were also documented. Statistical analysis was performed using a t test for continuous data and a ꭓ2 test for categorical data. Results: While there were differences in individual components of femoral offset and the horizontal hip center, mean difference in global offset was not statistically different between the CN (mean: 2.15 mm) and FO (mean: 1.85 mm) groups (P = .898). The number of outliers was also statistically insignificant. The CN group demonstrated significant improvement in mean leg length discrepancy (mean: 1.52 mm) in comparison to the FO group (mean: 2.26 mm) (P = .001), with 1.09% and 8.89% of outliers, respectively (P = .013). Conclusions: The addition of CN technology to DAA FF THA improved the accuracy and precision of restoring leg length. CN did not significantly affect global offset. There was no significant difference in complications between the CN and FO groups.http://www.sciencedirect.com/science/article/pii/S2352344124002620Total hip arthroplastyFemur-firstNavigationHip biomechanics |
| spellingShingle | Stephanie V. Kaszuba, MD Noah Gordon, BS Alex C. Gordon, MD The Addition of Navigation Technology to the Femur-First Approach in Anterior Total Hip Arthroplasty Improves Leg Length Restoration Arthroplasty Today Total hip arthroplasty Femur-first Navigation Hip biomechanics |
| title | The Addition of Navigation Technology to the Femur-First Approach in Anterior Total Hip Arthroplasty Improves Leg Length Restoration |
| title_full | The Addition of Navigation Technology to the Femur-First Approach in Anterior Total Hip Arthroplasty Improves Leg Length Restoration |
| title_fullStr | The Addition of Navigation Technology to the Femur-First Approach in Anterior Total Hip Arthroplasty Improves Leg Length Restoration |
| title_full_unstemmed | The Addition of Navigation Technology to the Femur-First Approach in Anterior Total Hip Arthroplasty Improves Leg Length Restoration |
| title_short | The Addition of Navigation Technology to the Femur-First Approach in Anterior Total Hip Arthroplasty Improves Leg Length Restoration |
| title_sort | addition of navigation technology to the femur first approach in anterior total hip arthroplasty improves leg length restoration |
| topic | Total hip arthroplasty Femur-first Navigation Hip biomechanics |
| url | http://www.sciencedirect.com/science/article/pii/S2352344124002620 |
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