title: Development and evaluation of an image-free computer-assisted impingement detection technique for total hip arthroplasty.
abstract: Periprosthetic or bony impingement in total hip arthroplasty (THA) has been correlated to dislocation, increased wear, reduced postoperative functionality with pain and/or decreased range of motion (ROM). We sought to study the accuracy and assess the reliability of measuring bony and periprosthetic impingement on a virtual bone model prior to the implantation of the acetabular cup with the help of image-free navigation technology in an experimental cadaver study. Impingement-free ROM measurements were recorded during minimally invasive, computer-assisted THA on 14 hips of 7 cadaveric donors. Preoperatively and postoperatively the donors were scanned using computed tomography (CT). Impingement-free ROM on three-dimensional CT-based models was then compared with corresponding, intraoperative navigation models. Bony/periprosthetic impingement can be detected with a mean accuracy limit of below 5° for motion angles, which should be reached after THA for activities of daily living with the help of image-free navigation technology.
authors: Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany. t.renkawitz@asklepios.com
authors: Tobias
authors: T
authors: Renkawitz
authors: Martin
authors: M
authors: Haimerl
authors: Lars
authors: L
authors: Dohmen
authors: Michael
authors: M
authors: Woerner
authors: Hans-Robert
authors: HR
authors: Springorum
authors: Ernst
authors: E
authors: Sendtner
authors: Guido
authors: G
authors: Heers
authors: Markus
authors: M
authors: Weber
authors: Joachim
authors: J
authors: Grifka
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D002102:Cadaver; D003198:Computer Simulation; D005260:Female; D057925:Femoracetabular Impingement / Q000209:etiology* / Q000503:physiopathology* / Q000517:prevention & control; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008954:Models, Biological; D011859:Radiography; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome
keywords: Computer-assisted orthopedic surgery; combined anteversion; femur first; imageless; minimally invasive; navigation; total hip arthroplasty