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Component placement accuracy of two digital intraoperative fluoroscopy supplementation systems in direct anterior total hip arthroplasty
Introduction Intraoperative fluoroscopy (IF) may increase accuracy of component placement when performing direct anterior approach total hip arthroplasty (THA), however, unguided IF continues to produce inconsistent results. Supplementation of IF, with a digital grid (Grid) system or digital overlay...
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| Published in: | Archives of orthopaedic and trauma surgery 2022-06, Vol.142 (6), p.1283-1288 |
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| container_title | Archives of orthopaedic and trauma surgery |
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| creator | Thorne, Tyler Nishioka, Scott Andrews, Samantha Mathews, Kristin Nakasone, Cass |
| description | Introduction
Intraoperative fluoroscopy (IF) may increase accuracy of component placement when performing direct anterior approach total hip arthroplasty (THA), however, unguided IF continues to produce inconsistent results. Supplementation of IF, with a digital grid (Grid) system or digital overlay (Overlay), may increase component placement accuracy. The purpose of this study was to compare component placement accuracy following THA when IF was supplemented with the Grid or Overlay technique.
Materials and methods
Acetabular abduction and anteversion, with leg length discrepancy (LLD) and global hip offset (GHO) were retrospectively evaluated for unilateral and bilateral THA patients from 6-week post-operative radiographs. Target component placement were GHO and LLD |
| doi_str_mv | 10.1007/s00402-021-04008-6 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2544457772</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2664957589</sourcerecordid><originalsourceid>FETCH-LOGICAL-c305t-a1b828c3bedd5159d70e1b63293c2361f0ce7dd69288a425efbfff0b296833713</originalsourceid><addsrcrecordid>eNp9kctu1jAQhS0EoqXwAiyQJTZsAuNL7GSJfpWLVIkNrC3HGbepktjYDihvwGPjv3-5iAUrH2m-c2bkQ8hzBq8ZgH6TASTwBjhrqoCuUQ_IOZNCNqJn6uFf-ow8yfkWgPGuh8fkTEimQGl5Tn4cwhLDimuhcbYOl6Oyzm3Jup0GT8v3QMfpeip2ptNakg0Rky3TN6R-3kIK2YW407zFON-56yysNO-54JKrpboTuhq6FkxTSLSEY9bNFKlN5SaFujeX_Sl55O2c8dn9e0G-vLv8fPjQXH16__Hw9qpxAtrSWDZ0vHNiwHFsWduPGpANSvBeOC4U8-BQj6PqeddZyVv0g_ceBt6rTgjNxAV5dcqNKXzdMBezTNnhPNsVw5YNb6WUrdaaV_TlP-ht2NJarzNcKdm3uu36SvET5epf5ITexDQtNu2GgTn2ZE49mdqTuevJqGp6cR-9DQuOvy2_iqmAOAG5jtZrTH92_yf2JxtkoWI</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2664957589</pqid></control><display><type>article</type><title>Component placement accuracy of two digital intraoperative fluoroscopy supplementation systems in direct anterior total hip arthroplasty</title><source>Springer Nature</source><creator>Thorne, Tyler ; Nishioka, Scott ; Andrews, Samantha ; Mathews, Kristin ; Nakasone, Cass</creator><creatorcontrib>Thorne, Tyler ; Nishioka, Scott ; Andrews, Samantha ; Mathews, Kristin ; Nakasone, Cass</creatorcontrib><description>Introduction
Intraoperative fluoroscopy (IF) may increase accuracy of component placement when performing direct anterior approach total hip arthroplasty (THA), however, unguided IF continues to produce inconsistent results. Supplementation of IF, with a digital grid (Grid) system or digital overlay (Overlay), may increase component placement accuracy. The purpose of this study was to compare component placement accuracy following THA when IF was supplemented with the Grid or Overlay technique.
Materials and methods
Acetabular abduction and anteversion, with leg length discrepancy (LLD) and global hip offset (GHO) were retrospectively evaluated for unilateral and bilateral THA patients from 6-week post-operative radiographs. Target component placement were GHO and LLD < 10 mm, abduction 45° ± 10° and anteversion 15° ± 10° for Overlay and 17° ± 10° for Grid. Differences between the Overlay and Grid were determined by univariate analyses.
Results
The Overlay and Grid groups included 178 patients (217 hips) and 262 patients (317 hips), respectively. Target placement with the Overlay and Grid was achieved for GHO in 98.3% and 95.7% of cases (
p
= 0.108), LLD in 100% and 98.4% of cases (
p
= 0.121), cup abduction in 98.2% and 97.4% of cases (
p
= 0.384), and cup anteversion in 97.7% and 71.1% of cases (
p
< 0.001), respectively. Surgical time was significantly longer in Overlay compared to Grid (Unilateral 77.5 ± 14.1 min and 68.8 ± 12.2;
p
< 0.001; Bilateral 184.6 ± 27.0 min and 165.5 ± 23.1;
p
< 0.001, respectively).
Conclusion
Although no difference was found between the Grid and the Overlay cohorts for LLD, GHO or abduction angle, the Overlay resulted in greater accuracy for acetabular component anteversion angle, with only a slight decrease in surgical efficiency.</description><identifier>ISSN: 1434-3916</identifier><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-021-04008-6</identifier><identifier>PMID: 34160674</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Accuracy ; Arthritis ; Fractures ; Hip Arthroplasty ; Joint replacement surgery ; Medicine ; Medicine & Public Health ; Orthopedics ; Osteoarthritis ; Patients ; Pelvis ; Trauma</subject><ispartof>Archives of orthopaedic and trauma surgery, 2022-06, Vol.142 (6), p.1283-1288</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021</rights><rights>2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c305t-a1b828c3bedd5159d70e1b63293c2361f0ce7dd69288a425efbfff0b296833713</citedby><cites>FETCH-LOGICAL-c305t-a1b828c3bedd5159d70e1b63293c2361f0ce7dd69288a425efbfff0b296833713</cites><orcidid>0000-0003-1378-7845</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34160674$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Thorne, Tyler</creatorcontrib><creatorcontrib>Nishioka, Scott</creatorcontrib><creatorcontrib>Andrews, Samantha</creatorcontrib><creatorcontrib>Mathews, Kristin</creatorcontrib><creatorcontrib>Nakasone, Cass</creatorcontrib><title>Component placement accuracy of two digital intraoperative fluoroscopy supplementation systems in direct anterior total hip arthroplasty</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description>Introduction
Intraoperative fluoroscopy (IF) may increase accuracy of component placement when performing direct anterior approach total hip arthroplasty (THA), however, unguided IF continues to produce inconsistent results. Supplementation of IF, with a digital grid (Grid) system or digital overlay (Overlay), may increase component placement accuracy. The purpose of this study was to compare component placement accuracy following THA when IF was supplemented with the Grid or Overlay technique.
Materials and methods
Acetabular abduction and anteversion, with leg length discrepancy (LLD) and global hip offset (GHO) were retrospectively evaluated for unilateral and bilateral THA patients from 6-week post-operative radiographs. Target component placement were GHO and LLD < 10 mm, abduction 45° ± 10° and anteversion 15° ± 10° for Overlay and 17° ± 10° for Grid. Differences between the Overlay and Grid were determined by univariate analyses.
Results
The Overlay and Grid groups included 178 patients (217 hips) and 262 patients (317 hips), respectively. Target placement with the Overlay and Grid was achieved for GHO in 98.3% and 95.7% of cases (
p
= 0.108), LLD in 100% and 98.4% of cases (
p
= 0.121), cup abduction in 98.2% and 97.4% of cases (
p
= 0.384), and cup anteversion in 97.7% and 71.1% of cases (
p
< 0.001), respectively. Surgical time was significantly longer in Overlay compared to Grid (Unilateral 77.5 ± 14.1 min and 68.8 ± 12.2;
p
< 0.001; Bilateral 184.6 ± 27.0 min and 165.5 ± 23.1;
p
< 0.001, respectively).
Conclusion
Although no difference was found between the Grid and the Overlay cohorts for LLD, GHO or abduction angle, the Overlay resulted in greater accuracy for acetabular component anteversion angle, with only a slight decrease in surgical efficiency.</description><subject>Accuracy</subject><subject>Arthritis</subject><subject>Fractures</subject><subject>Hip Arthroplasty</subject><subject>Joint replacement surgery</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedics</subject><subject>Osteoarthritis</subject><subject>Patients</subject><subject>Pelvis</subject><subject>Trauma</subject><issn>1434-3916</issn><issn>0936-8051</issn><issn>1434-3916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kctu1jAQhS0EoqXwAiyQJTZsAuNL7GSJfpWLVIkNrC3HGbepktjYDihvwGPjv3-5iAUrH2m-c2bkQ8hzBq8ZgH6TASTwBjhrqoCuUQ_IOZNCNqJn6uFf-ow8yfkWgPGuh8fkTEimQGl5Tn4cwhLDimuhcbYOl6Oyzm3Jup0GT8v3QMfpeip2ptNakg0Rky3TN6R-3kIK2YW407zFON-56yysNO-54JKrpboTuhq6FkxTSLSEY9bNFKlN5SaFujeX_Sl55O2c8dn9e0G-vLv8fPjQXH16__Hw9qpxAtrSWDZ0vHNiwHFsWduPGpANSvBeOC4U8-BQj6PqeddZyVv0g_ceBt6rTgjNxAV5dcqNKXzdMBezTNnhPNsVw5YNb6WUrdaaV_TlP-ht2NJarzNcKdm3uu36SvET5epf5ITexDQtNu2GgTn2ZE49mdqTuevJqGp6cR-9DQuOvy2_iqmAOAG5jtZrTH92_yf2JxtkoWI</recordid><startdate>20220601</startdate><enddate>20220601</enddate><creator>Thorne, Tyler</creator><creator>Nishioka, Scott</creator><creator>Andrews, Samantha</creator><creator>Mathews, Kristin</creator><creator>Nakasone, Cass</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1378-7845</orcidid></search><sort><creationdate>20220601</creationdate><title>Component placement accuracy of two digital intraoperative fluoroscopy supplementation systems in direct anterior total hip arthroplasty</title><author>Thorne, Tyler ; Nishioka, Scott ; Andrews, Samantha ; Mathews, Kristin ; Nakasone, Cass</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c305t-a1b828c3bedd5159d70e1b63293c2361f0ce7dd69288a425efbfff0b296833713</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Accuracy</topic><topic>Arthritis</topic><topic>Fractures</topic><topic>Hip Arthroplasty</topic><topic>Joint replacement surgery</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedics</topic><topic>Osteoarthritis</topic><topic>Patients</topic><topic>Pelvis</topic><topic>Trauma</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Thorne, Tyler</creatorcontrib><creatorcontrib>Nishioka, Scott</creatorcontrib><creatorcontrib>Andrews, Samantha</creatorcontrib><creatorcontrib>Mathews, Kristin</creatorcontrib><creatorcontrib>Nakasone, Cass</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of orthopaedic and trauma surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Thorne, Tyler</au><au>Nishioka, Scott</au><au>Andrews, Samantha</au><au>Mathews, Kristin</au><au>Nakasone, Cass</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Component placement accuracy of two digital intraoperative fluoroscopy supplementation systems in direct anterior total hip arthroplasty</atitle><jtitle>Archives of orthopaedic and trauma surgery</jtitle><stitle>Arch Orthop Trauma Surg</stitle><addtitle>Arch Orthop Trauma Surg</addtitle><date>2022-06-01</date><risdate>2022</risdate><volume>142</volume><issue>6</issue><spage>1283</spage><epage>1288</epage><pages>1283-1288</pages><issn>1434-3916</issn><issn>0936-8051</issn><eissn>1434-3916</eissn><abstract>Introduction
Intraoperative fluoroscopy (IF) may increase accuracy of component placement when performing direct anterior approach total hip arthroplasty (THA), however, unguided IF continues to produce inconsistent results. Supplementation of IF, with a digital grid (Grid) system or digital overlay (Overlay), may increase component placement accuracy. The purpose of this study was to compare component placement accuracy following THA when IF was supplemented with the Grid or Overlay technique.
Materials and methods
Acetabular abduction and anteversion, with leg length discrepancy (LLD) and global hip offset (GHO) were retrospectively evaluated for unilateral and bilateral THA patients from 6-week post-operative radiographs. Target component placement were GHO and LLD < 10 mm, abduction 45° ± 10° and anteversion 15° ± 10° for Overlay and 17° ± 10° for Grid. Differences between the Overlay and Grid were determined by univariate analyses.
Results
The Overlay and Grid groups included 178 patients (217 hips) and 262 patients (317 hips), respectively. Target placement with the Overlay and Grid was achieved for GHO in 98.3% and 95.7% of cases (
p
= 0.108), LLD in 100% and 98.4% of cases (
p
= 0.121), cup abduction in 98.2% and 97.4% of cases (
p
= 0.384), and cup anteversion in 97.7% and 71.1% of cases (
p
< 0.001), respectively. Surgical time was significantly longer in Overlay compared to Grid (Unilateral 77.5 ± 14.1 min and 68.8 ± 12.2;
p
< 0.001; Bilateral 184.6 ± 27.0 min and 165.5 ± 23.1;
p
< 0.001, respectively).
Conclusion
Although no difference was found between the Grid and the Overlay cohorts for LLD, GHO or abduction angle, the Overlay resulted in greater accuracy for acetabular component anteversion angle, with only a slight decrease in surgical efficiency.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>34160674</pmid><doi>10.1007/s00402-021-04008-6</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-1378-7845</orcidid></addata></record> |
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| source | Springer Nature |
| subjects | Accuracy Arthritis Fractures Hip Arthroplasty Joint replacement surgery Medicine Medicine & Public Health Orthopedics Osteoarthritis Patients Pelvis Trauma |
| title | Component placement accuracy of two digital intraoperative fluoroscopy supplementation systems in direct anterior total hip arthroplasty |
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