Precision of Cup Positioning Using a Novel Computed Tomography Based Navigation System in Total Hip Arthroplasty

Abstract

Background and Objectives: Navigation systems are designed to enhance surgical precision, improving patient outcomes and reducing the risk of implant misplacement. In this study, we have evaluated a novel orthopedic surgical platform that utilizes CT imaging with AI-based algorithms to automate several critical aspects of total hip arthroplasty. It contains three modules—preoperative planning, navigation during surgery, and follow-up analysis. The primary objective of the current study was to evaluate the precision of the navigation tool in cup placement, i.e., whether the information displayed for navigation correctly reflected the actual position of the implant. Materials and Methods: Surgery outcomes of 15 inter-rater measurements on human cadavers and 18 surgeries on patients who underwent total hip replacement using the navigation tool were analyzed. Results: In the inter-rater assessment, the mean errors were −0.31 ± 1.42° for anteversion, 1.06 ± 1.73° for inclination, and −0.94 ± 1.76 mm for cup position depth. In patients’ surgeries, the mean errors were −0.07 ± 2.72° for anteversion, −0.2 ± 0.86° for inclination, and 0.28 ± 0.78 mm for cup depth. Conclusions: The navigation tool offers intra-operative guidance on notable precision in cup placement, thereby effectively mitigating the risk of cup malpositioning outside the patient-specific safe zone.

Keywords

• total hip arthroplasty
• computer-assisted
• navigation
• artificial intelligence