How Much Does a Computed Tomography-Based Mixed-Reality Navigation System Change Freehand Acetabular Component Position?

Background: This study evaluates how a computed tomography-based mixed-reality (MR) navigation system impacts acetabular component orientation compared to freehand positioning in total hip arthroplasty. Methods: A series of 79 patients who underwent total hip arthroplasty utilizing a computed tomogr...

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Main Authors: Justin Leal, BS, Alexander F. Heimann, MD, Eric S. Dilbone, MD, Sean P. Ryan, MD, Samuel S. Wellman, MD
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:Arthroplasty Today
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352344125000482
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author Justin Leal, BS
Alexander F. Heimann, MD
Eric S. Dilbone, MD
Sean P. Ryan, MD
Samuel S. Wellman, MD
author_facet Justin Leal, BS
Alexander F. Heimann, MD
Eric S. Dilbone, MD
Sean P. Ryan, MD
Samuel S. Wellman, MD
author_sort Justin Leal, BS
collection DOAJ
description Background: This study evaluates how a computed tomography-based mixed-reality (MR) navigation system impacts acetabular component orientation compared to freehand positioning in total hip arthroplasty. Methods: A series of 79 patients who underwent total hip arthroplasty utilizing a computed tomography-based MR navigation system were reviewed. The surgeon initially placed the acetabular cup freehand, attempting to achieve the preoperative plan, and this initial intraoperative orientation was recorded. The cup was then adjusted to the planned position. The difference between freehand and planned tilt-adjusted operative anteversion (OA) and inclination (OI) determined the navigation tool’s impact. Results: The mean preoperative planned OA was 30.1 ± 2.0 (range: 25, 35) degrees, and the mean freehand intraoperative OA was 30.2 ± 9.1 (range: 4, 57) degrees (P = .885), requiring a mean adjustment of 6.8 ± 5.1 (range: 0, 23) degrees. Freehand OA was corrected at least 5 degrees in 54.4% (43/79) of cases. The mean preoperative planned OI was 40.8 ± 0.6 (range: 39, 42) degrees, and the mean freehand intraoperative OI was 37.8 ± 6.6 (range: 18, 53) degrees (P < .001), requiring a mean adjustment of 5.7 ± 4.5 (range: 0, 22) degrees to achieve. Freehand OI was corrected at least 5 degrees in 43.0% (34/79) of cases. Conclusions: Freehand acetabular component positioning in the lateral position is variable when attempting to execute patient-specific numerical cup orientation targets. Use of this navigation tool led the surgeon to correct more than 5 degrees in both OA and OI in roughly half of the hips.
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spelling doaj-art-c3f5a733c09144299bb1dc1fe1bdebdd2025-08-20T03:06:41ZengElsevierArthroplasty Today2352-34412025-04-013210166110.1016/j.artd.2025.101661How Much Does a Computed Tomography-Based Mixed-Reality Navigation System Change Freehand Acetabular Component Position?Justin Leal, BS0Alexander F. Heimann, MD1Eric S. Dilbone, MD2Sean P. Ryan, MD3Samuel S. Wellman, MD4Department of Orthopaedic Surgery, Duke University, Durham, NC, USA; Corresponding author. Justin Leal, BS, Department of Orthopaedic Surgery, Duke University, 5601 Arringdon Park Dr. Suite 300, Morrisville, NC 27560, USA. Tel.: +1 305 409 2237.Department of Orthopaedic Surgery and Traumatology, HFR Fribourg – Cantonal Hospital, University of Fribourg, Fribourg, SwitzerlandDepartment of Orthopaedic Surgery, Duke University, Durham, NC, USADepartment of Orthopaedic Surgery, Duke University, Durham, NC, USADepartment of Orthopaedic Surgery, Duke University, Durham, NC, USABackground: This study evaluates how a computed tomography-based mixed-reality (MR) navigation system impacts acetabular component orientation compared to freehand positioning in total hip arthroplasty. Methods: A series of 79 patients who underwent total hip arthroplasty utilizing a computed tomography-based MR navigation system were reviewed. The surgeon initially placed the acetabular cup freehand, attempting to achieve the preoperative plan, and this initial intraoperative orientation was recorded. The cup was then adjusted to the planned position. The difference between freehand and planned tilt-adjusted operative anteversion (OA) and inclination (OI) determined the navigation tool’s impact. Results: The mean preoperative planned OA was 30.1 ± 2.0 (range: 25, 35) degrees, and the mean freehand intraoperative OA was 30.2 ± 9.1 (range: 4, 57) degrees (P = .885), requiring a mean adjustment of 6.8 ± 5.1 (range: 0, 23) degrees. Freehand OA was corrected at least 5 degrees in 54.4% (43/79) of cases. The mean preoperative planned OI was 40.8 ± 0.6 (range: 39, 42) degrees, and the mean freehand intraoperative OI was 37.8 ± 6.6 (range: 18, 53) degrees (P < .001), requiring a mean adjustment of 5.7 ± 4.5 (range: 0, 22) degrees to achieve. Freehand OI was corrected at least 5 degrees in 43.0% (34/79) of cases. Conclusions: Freehand acetabular component positioning in the lateral position is variable when attempting to execute patient-specific numerical cup orientation targets. Use of this navigation tool led the surgeon to correct more than 5 degrees in both OA and OI in roughly half of the hips.http://www.sciencedirect.com/science/article/pii/S2352344125000482Total hip arthroplasty (THA)Augmented-reality (AR)Mixed-reality (MR)InclinationAnteversion
spellingShingle Justin Leal, BS
Alexander F. Heimann, MD
Eric S. Dilbone, MD
Sean P. Ryan, MD
Samuel S. Wellman, MD
How Much Does a Computed Tomography-Based Mixed-Reality Navigation System Change Freehand Acetabular Component Position?
Arthroplasty Today
Total hip arthroplasty (THA)
Augmented-reality (AR)
Mixed-reality (MR)
Inclination
Anteversion
title How Much Does a Computed Tomography-Based Mixed-Reality Navigation System Change Freehand Acetabular Component Position?
title_full How Much Does a Computed Tomography-Based Mixed-Reality Navigation System Change Freehand Acetabular Component Position?
title_fullStr How Much Does a Computed Tomography-Based Mixed-Reality Navigation System Change Freehand Acetabular Component Position?
title_full_unstemmed How Much Does a Computed Tomography-Based Mixed-Reality Navigation System Change Freehand Acetabular Component Position?
title_short How Much Does a Computed Tomography-Based Mixed-Reality Navigation System Change Freehand Acetabular Component Position?
title_sort how much does a computed tomography based mixed reality navigation system change freehand acetabular component position
topic Total hip arthroplasty (THA)
Augmented-reality (AR)
Mixed-reality (MR)
Inclination
Anteversion
url http://www.sciencedirect.com/science/article/pii/S2352344125000482
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