Comparison of the accuracies of computed tomography-based navigation and image-free navigation for acetabular cup insertion in total hip arthroplasty in the lateral decubitus position

Figures & data

Table 1. The accuracy of cup orientation (difference between the intraoperative record and the postoperative measurement).

Navigation	Authors	Company	Inclination (°)	Inclination (°) (Absolute Value)	Anteversion (°)	Anteversion (°) (Absolute Value)
CT-based	Iwana D et al. [13]	Stryker	0.5 ± 2.3	1.8 ± 1.6	−0.3 ± 1.6	1.2 ± 1.1
	Kalteis T et al. [14]	Brainlab	–	3.0 ± 2.6	–	3.3 ± 2.3
	Yamada K et al. [15]	Brainlab^a	–	2.5 ± 2.2	–	2.3 ± 1.7
	Yamada K et al. [15]	Brainlab^b	–	4.6 ± 3.3	–	4.4 ± 3.3
	Tsutsui T et al. [16]	Stryker	–	1.5 ± 1.3	–	2.1 ± 1.8
	Present study	Brainlab^a	–	1.9 ± 1.5	–	3.0 ± 2.3
Image free	Kalteis T et al. [14]	Brainlab	–	2.9 ± 2.2	–	4.2 ± 3.3
	Lass R et al. [7]	ORTHOsoft	–	3.2 ± 2.4	–	6.5 ± 3.7
	Sendtner E et al. [17]	Brainlab	0.4 ± 3.3	–	−5.6 ± 6.5	–
	Tsukada S and Wakui M [18]	B. Braun Aesculap	–	2.4 ± 2.0	–	3.7 ± 2.3
	Davis ET et al. [19]	Brainlab^c	−1.8 ± 1.8	–	−4.8 ± 2.7	–
	Davis ET et al. [19]	Brainlab^d	−1.1 ± 3.1	–	0.9 ± 4.3	–
	Present study	Brainlab^d	−	4.4 ± 4.2	–	7.1 ± 6.3
	–	Brainlab^e	–	2.1 ± 1.8	–	4.1 ± 3.6

^aCT-based 2D–3D matched navigation, ^bpaired-point matched navigation, ^cbilateral ASIS and pubis registration, ^dipsilateral ASIS and L5 spinous process registration, ^ebilateral ASIS registration.

2D–3D: 2-dimensional to 3-dimensional; ASIS: anterior superior iliac spine.

Figure 1. Consoles of CT-based navigation and image-free navigation.

Table 2. Patients' characteristics.

	All	Group I (n = 31)	Group II (n = 32)	p
Age (years)	(n = 63)	60.5 ± 9.6	63.6 ± 11.1	.171
Gender
Male	9	5	4	0>.999
Female	54	27	27
BMI	–	23.9 ± 4.1	24.8 ± 5.1	.465
Diagnosis
Hip Dysplasia	57	28	29	0>.999
ION	3	2	1
RA	3	2	1
Crowe Group
Group 1	58	30	28	.803
Group 2	3	1	2
Group 3	2	1	1

BMI: body mass index; ION: idiopathic osteonecrosis of the femoral head; RA: rheumatoid arthritis.

Figure 2. 3D computed tomography. (A) APP is flat in a neutral position (parallel to CT scan table). (B) APP is 15° anteverted compared with CT scan table.

Figure 3. Screen shots of (A) CT-based navigation and (B) image-free navigation at the time of cup placement.

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