Does a computed tomography-based navigation system reduce the risk of dislocation after total hip arthroplasty in patients with osteonecrosis of the femoral head? A propensity score analysis

• Published in: Journal of artificial organs 2020-09, Vol.23 (3), p.247-254
• Main Authors: Takashima, Kazuma, Sakai, Takashi, Amano, Shu, Hamada, Hidetoshi, Ando, Wataru, Takao, Masaki, Hamasaki, Toshimitsu, Nakamura, Nobuo, Sugano, Nobuhiko
• Format: Article
• Language: English
• Subjects: Adult; Aged; Arthroplasty, Replacement, Hip - adverse effects; Arthroplasty, Replacement, Hip - methods; Biomedical Engineering and Bioengineering; Biomedical materials; Body mass; Body mass index; Body size; Bone implants; Cardiac Surgery; Computed tomography; Confidence intervals; Female; Femur; Femur Head Necrosis - complications; Femur Head Necrosis - diagnostic imaging; Femur Head Necrosis - surgery; Hip; Hip dislocation; Hip Joint - surgery; Hip Prosthesis; Humans; Joint diseases; Joint Dislocations - etiology; Joint Dislocations - prevention & control; Joint replacement surgery; Joint surgery; Loosening; Male; Medicine; Medicine & Public Health; Middle Aged; Navigation systems; Nephrology; Original Article; Osteonecrosis; Patients; Propensity Score; Regression analysis; Retrospective Studies; Statistical analysis; Surgery; Surgery, Computer-Assisted - adverse effects; Surgery, Computer-Assisted - methods; Surgical implants; Tomography, X-Ray Computed; Total hip arthroplasty
• ISSN: 1434-7229; 1619-0904
• DOI: 10.1007/s10047-020-01158-z

This study aimed to investigate whether use of a computed tomography (CT)-based navigation system reduce the risk of dislocation after total hip arthroplasty (THA) in patients with osteonecrosis of the femoral head (ONFH). A total of 271 hips from 192 consecutive patients that underwent primary THA for ONFH were included. There were 110 hips in non-navigation group, and 161 hips in navigation group. After applying exclusion criteria, 209 hips from 149 patients were selected for analysis. Clinical outcomes and complication rates were evaluated, and implant alignments were also calculated. To identify whether the navigation system was useful to prevent dislocation, the inverse probability of treatment-weighted Cox regression analysis using a propensity score in relationship to sex, age at surgery, body mass index, and femoral head size was performed. No significant difference was observed in clinical scores between both groups. Dislocation was significantly lower in the navigation group (3 hips, 2.7%) than in the non-navigation group (11 hips, 11.2%; p  = 0.012), whereas periprosthetic joint infection and aseptic loosening did not differ between the groups. Variance of cup inclination and anteversion angles was smaller in the navigation group than in the non-navigation group ( p