title: Limitations of imageless computer-assisted navigation for total hip arthroplasty.
abstract: We prospectively evaluated acetabular cup placement in total hip arthroplasty with an imageless computer navigation system or using conventional manual technique. The achieved cup orientation in the manual group had substantially larger variances and greater placement error than the navigation cases. The use of navigation was abandoned in 3 cases because of excessive pelvic tilt and unreliable registration of the pelvis. Computer navigation system helped improve the accuracy of the acetabular cup placement for total hip arthroplasty in this study. The variation between the intraoperative navigation readings and the computed tomographic values suggests that relying on palpation of bony landmarks through drapes and tissue is a limitation of this method. Further, the variation in pelvic tilt has an effect on cup placement that requires further studies.
authors.affiliation: Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, Illinois 60611, USA.
authors.forename: Fang
authors.initials: F
authors.lastname: Lin
authors.forename: Dohyung
authors.initials: D
authors.lastname: Lim
authors.forename: Richard L
authors.initials: RL
authors.lastname: Wixson
authors.forename: Steven
authors.initials: S
authors.lastname: Milos
authors.forename: Ronald W
authors.initials: RW
authors.lastname: Hendrix
authors.forename: Mohsen
authors.initials: M
authors.lastname: Makhsous
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000601:surgery; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D017760:Bone Malalignment / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D005471:Fluoroscopy; D006617:Hip Dislocation / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000009:adverse effects / Q000379:methods*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D015207:Osteoarthritis, Hip / Q000601:surgery*; D011446:Prospective Studies; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000379:methods*; D014057:Tomography, X-Ray Computed