Impact of CT-based navigation, large femoral head, and dual-mobility liner on achieving the required range of motion in total hip arthroplasty
Aims: This study aimed to investigate whether the use of CT-based navigation enhances: 1) the accuracy of cup placement; and 2) the achievement rate of required range of motion (ROM). Additionally, we investigated the impact of using a large femoral head and dual-mobility liner on the achievement r...
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The British Editorial Society of Bone & Joint Surgery
2025-02-01
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| Series: | Bone & Joint Open |
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| Online Access: | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.62.BJO-2024-0084.R1 |
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| author | Toshiki Konishi Satoshi Hamai Shinya Kawahara Daisuke Hara Taishi Sato Goro Motomura Takeshi Utsunomiya Yasuharu Nakashima |
| author_facet | Toshiki Konishi Satoshi Hamai Shinya Kawahara Daisuke Hara Taishi Sato Goro Motomura Takeshi Utsunomiya Yasuharu Nakashima |
| author_sort | Toshiki Konishi |
| collection | DOAJ |
| description | Aims: This study aimed to investigate whether the use of CT-based navigation enhances: 1) the accuracy of cup placement; and 2) the achievement rate of required range of motion (ROM). Additionally, we investigated the impact of using a large femoral head and dual-mobility liner on the achievement rates. Methods: This retrospective study analyzed 60 manual and 51 CT-based navigated primary total hip arthroplasties performed at a single facility. Postoperative CT scans and CT-based simulation software were employed to measure the cup orientation and to simulate the ROM. We compared the absolute errors for radiological inclination (RI) and radiological anteversion (RA) between the two groups. We also examined whether the simulated ROM met the required ROM criteria, defined as flexion > 110°, internal rotation > 30°, extension > 30°, and external rotation > 30°. Furthermore, we performed simulations with 36 mm femoral head and dual-mobility liner. Results: The absolute errors of RI and RA from the preoperative plan were significantly smaller in the CT-based navigation group (3.7° (SD 3.5°) vs 5.1° (SD 3.5°); p = 0.022, and 3.9° (SD 3.5°) vs 6.8° (SD 5.0°); p = 0.001, respectively). The proportion of cases achieving the required ROM in all directions was significantly higher in the CT-based navigation group (42% vs 63%; p = 0.036). The achievement rates of the required ROM were significantly higher with the use of a 36 mm ball or dual-mobility liner compared to the use of a 32 mm ball (65% vs 51%; p = 0.040 and 77% vs 51%; p ≤ 0.001, respectively). Conclusion: CT-based navigation enhanced required ROM achievement rates by > 20%, regardless of the ball diameter. The improved accuracy of cup placement through CT-based navigation likely contributed to the enhancement. Furthermore, the use of large femoral heads and dual-mobility liners also improved the required ROM achievement rates. In cases with a high risk of dislocation, use of these devices is preferred. Cite this article: Bone Jt Open 2025;6(2):155–163. |
| format | Article |
| id | doaj-art-ec03bf1531184b49a42c705df213a41f |
| institution | DOAJ |
| issn | 2633-1462 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | The British Editorial Society of Bone & Joint Surgery |
| record_format | Article |
| series | Bone & Joint Open |
| spelling | doaj-art-ec03bf1531184b49a42c705df213a41f2025-08-20T03:15:57ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Open2633-14622025-02-016215516310.1302/2633-1462.62.BJO-2024-0084.R1Impact of CT-based navigation, large femoral head, and dual-mobility liner on achieving the required range of motion in total hip arthroplastyToshiki Konishi0Satoshi Hamai1https://orcid.org/0000-0001-6302-2539Shinya Kawahara2Daisuke Hara3Taishi Sato4Goro Motomura5Takeshi Utsunomiya6Yasuharu Nakashima7Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JapanDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JapanDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JapanDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JapanDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JapanDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JapanDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JapanDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JapanAims: This study aimed to investigate whether the use of CT-based navigation enhances: 1) the accuracy of cup placement; and 2) the achievement rate of required range of motion (ROM). Additionally, we investigated the impact of using a large femoral head and dual-mobility liner on the achievement rates. Methods: This retrospective study analyzed 60 manual and 51 CT-based navigated primary total hip arthroplasties performed at a single facility. Postoperative CT scans and CT-based simulation software were employed to measure the cup orientation and to simulate the ROM. We compared the absolute errors for radiological inclination (RI) and radiological anteversion (RA) between the two groups. We also examined whether the simulated ROM met the required ROM criteria, defined as flexion > 110°, internal rotation > 30°, extension > 30°, and external rotation > 30°. Furthermore, we performed simulations with 36 mm femoral head and dual-mobility liner. Results: The absolute errors of RI and RA from the preoperative plan were significantly smaller in the CT-based navigation group (3.7° (SD 3.5°) vs 5.1° (SD 3.5°); p = 0.022, and 3.9° (SD 3.5°) vs 6.8° (SD 5.0°); p = 0.001, respectively). The proportion of cases achieving the required ROM in all directions was significantly higher in the CT-based navigation group (42% vs 63%; p = 0.036). The achievement rates of the required ROM were significantly higher with the use of a 36 mm ball or dual-mobility liner compared to the use of a 32 mm ball (65% vs 51%; p = 0.040 and 77% vs 51%; p ≤ 0.001, respectively). Conclusion: CT-based navigation enhanced required ROM achievement rates by > 20%, regardless of the ball diameter. The improved accuracy of cup placement through CT-based navigation likely contributed to the enhancement. Furthermore, the use of large femoral heads and dual-mobility liners also improved the required ROM achievement rates. In cases with a high risk of dislocation, use of these devices is preferred. Cite this article: Bone Jt Open 2025;6(2):155–163.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.62.BJO-2024-0084.R1total hip arthroplastyct-based navigationrequired range of motionimpingementlarger femoral headstotal hip arthroplasty (tha)flexionfemoral headct scansprimary total hip arthroplastieshipspearson’s chi-squared testdual-mobility implantsrandomized controlled trial |
| spellingShingle | Toshiki Konishi Satoshi Hamai Shinya Kawahara Daisuke Hara Taishi Sato Goro Motomura Takeshi Utsunomiya Yasuharu Nakashima Impact of CT-based navigation, large femoral head, and dual-mobility liner on achieving the required range of motion in total hip arthroplasty Bone & Joint Open total hip arthroplasty ct-based navigation required range of motion impingement larger femoral heads total hip arthroplasty (tha) flexion femoral head ct scans primary total hip arthroplasties hips pearson’s chi-squared test dual-mobility implants randomized controlled trial |
| title | Impact of CT-based navigation, large femoral head, and dual-mobility liner on achieving the required range of motion in total hip arthroplasty |
| title_full | Impact of CT-based navigation, large femoral head, and dual-mobility liner on achieving the required range of motion in total hip arthroplasty |
| title_fullStr | Impact of CT-based navigation, large femoral head, and dual-mobility liner on achieving the required range of motion in total hip arthroplasty |
| title_full_unstemmed | Impact of CT-based navigation, large femoral head, and dual-mobility liner on achieving the required range of motion in total hip arthroplasty |
| title_short | Impact of CT-based navigation, large femoral head, and dual-mobility liner on achieving the required range of motion in total hip arthroplasty |
| title_sort | impact of ct based navigation large femoral head and dual mobility liner on achieving the required range of motion in total hip arthroplasty |
| topic | total hip arthroplasty ct-based navigation required range of motion impingement larger femoral heads total hip arthroplasty (tha) flexion femoral head ct scans primary total hip arthroplasties hips pearson’s chi-squared test dual-mobility implants randomized controlled trial |
| url | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.62.BJO-2024-0084.R1 |
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