Evaluating Alternative Registration Planes in Imageless, Computer-Assisted Navigation Systems for Direct Anterior Total Hip Arthroplasty

(1) Background: Imageless computer navigation systems have the potential to improve the accuracy of acetabular cup position in total hip arthroplasty (THA). Popular imageless navigation methods include locating the patient in a three-dimensional space (registration method) while using a baseline to...

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Main Authors: John E. Farey, Yuan Chai, Joshua Xu, Vincent Maes, Ameneh Sadeghpour, Neri A. Baker, Jonathan M. Vigdorchik, William L. Walter
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Sensors
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Online Access:https://www.mdpi.com/1424-8220/24/21/7092
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author John E. Farey
Yuan Chai
Joshua Xu
Vincent Maes
Ameneh Sadeghpour
Neri A. Baker
Jonathan M. Vigdorchik
William L. Walter
author_facet John E. Farey
Yuan Chai
Joshua Xu
Vincent Maes
Ameneh Sadeghpour
Neri A. Baker
Jonathan M. Vigdorchik
William L. Walter
author_sort John E. Farey
collection DOAJ
description (1) Background: Imageless computer navigation systems have the potential to improve the accuracy of acetabular cup position in total hip arthroplasty (THA). Popular imageless navigation methods include locating the patient in a three-dimensional space (registration method) while using a baseline to angle the acetabular cup (reference plane). This study aims to compare the accuracy of different methods for determining postoperative acetabular cup positioning in THA via the direct anterior approach. (2) Methods: Fifty-one participants were recruited. Optical and inertial sensor imageless navigation systems were used simultaneously with three combinations of registration methods and reference planes: the anterior pelvic plane (APP), the anterior superior iliac spine (ASIS) and the table tilt (TT) method. Postoperative acetabular cup position, inclination, and anteversion were assessed using CT scans. (3) Results: For inclination, the mean absolute error (MAE) was lower using the TT method (2.4° ± 1.7°) compared to the ASIS (2.8° ± 1.7°, <i>p</i> = 0.17) and APP method (3.7° ± 2.1°, <i>p</i> < 0.001). For anteversion, the MAE was significantly lower for the TT method (2.4° ± 1.8°) in contrast to the ASIS (3.9° ± 3.2°, <i>p</i> = 0.005) and APP method (9.1° ± 6.2°, <i>p</i> < 0.001). (4) Conclusion: A functional reference plane is superior to an anatomic reference plane to accurately measure intraoperative acetabular cup inclination and anteversion in THA using inertial imageless navigation systems.
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spelling doaj-art-bf477bb8f3eb4adc9fefc573fa775c772025-08-20T02:13:19ZengMDPI AGSensors1424-82202024-11-012421709210.3390/s24217092Evaluating Alternative Registration Planes in Imageless, Computer-Assisted Navigation Systems for Direct Anterior Total Hip ArthroplastyJohn E. Farey0Yuan Chai1Joshua Xu2Vincent Maes3Ameneh Sadeghpour4Neri A. Baker5Jonathan M. Vigdorchik6William L. Walter7Sydney Musculoskeletal Health, Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2064, AustraliaSydney Musculoskeletal Health, Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2064, AustraliaDepartment of Orthopedics and Traumatic Surgery, Royal North Shore Hospital, St Leonards, NSW 2065, AustraliaSydney Musculoskeletal Health, Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2064, AustraliaInnovation Department, Navbit, Sydney, NSW 2000, AustraliaInnovation Department, Navbit, Sydney, NSW 2000, AustraliaAdult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, NY 10021, USASydney Musculoskeletal Health, Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2064, Australia(1) Background: Imageless computer navigation systems have the potential to improve the accuracy of acetabular cup position in total hip arthroplasty (THA). Popular imageless navigation methods include locating the patient in a three-dimensional space (registration method) while using a baseline to angle the acetabular cup (reference plane). This study aims to compare the accuracy of different methods for determining postoperative acetabular cup positioning in THA via the direct anterior approach. (2) Methods: Fifty-one participants were recruited. Optical and inertial sensor imageless navigation systems were used simultaneously with three combinations of registration methods and reference planes: the anterior pelvic plane (APP), the anterior superior iliac spine (ASIS) and the table tilt (TT) method. Postoperative acetabular cup position, inclination, and anteversion were assessed using CT scans. (3) Results: For inclination, the mean absolute error (MAE) was lower using the TT method (2.4° ± 1.7°) compared to the ASIS (2.8° ± 1.7°, <i>p</i> = 0.17) and APP method (3.7° ± 2.1°, <i>p</i> < 0.001). For anteversion, the MAE was significantly lower for the TT method (2.4° ± 1.8°) in contrast to the ASIS (3.9° ± 3.2°, <i>p</i> = 0.005) and APP method (9.1° ± 6.2°, <i>p</i> < 0.001). (4) Conclusion: A functional reference plane is superior to an anatomic reference plane to accurately measure intraoperative acetabular cup inclination and anteversion in THA using inertial imageless navigation systems.https://www.mdpi.com/1424-8220/24/21/7092computer assisted surgeryimageless navigationoptical sensortotal hip arthroplastyacetabular orientationregistration plane
spellingShingle John E. Farey
Yuan Chai
Joshua Xu
Vincent Maes
Ameneh Sadeghpour
Neri A. Baker
Jonathan M. Vigdorchik
William L. Walter
Evaluating Alternative Registration Planes in Imageless, Computer-Assisted Navigation Systems for Direct Anterior Total Hip Arthroplasty
Sensors
computer assisted surgery
imageless navigation
optical sensor
total hip arthroplasty
acetabular orientation
registration plane
title Evaluating Alternative Registration Planes in Imageless, Computer-Assisted Navigation Systems for Direct Anterior Total Hip Arthroplasty
title_full Evaluating Alternative Registration Planes in Imageless, Computer-Assisted Navigation Systems for Direct Anterior Total Hip Arthroplasty
title_fullStr Evaluating Alternative Registration Planes in Imageless, Computer-Assisted Navigation Systems for Direct Anterior Total Hip Arthroplasty
title_full_unstemmed Evaluating Alternative Registration Planes in Imageless, Computer-Assisted Navigation Systems for Direct Anterior Total Hip Arthroplasty
title_short Evaluating Alternative Registration Planes in Imageless, Computer-Assisted Navigation Systems for Direct Anterior Total Hip Arthroplasty
title_sort evaluating alternative registration planes in imageless computer assisted navigation systems for direct anterior total hip arthroplasty
topic computer assisted surgery
imageless navigation
optical sensor
total hip arthroplasty
acetabular orientation
registration plane
url https://www.mdpi.com/1424-8220/24/21/7092
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