Abstract
Background:Computer-assisted navigation has proven effective at improving the accuracy of component placement during Total Hip Arthroplasty (THA); however, the material costs, line-of-site issues and potential for significant time increases have limited their widespread use.Objective:The purpose of this study was to investigate the impact of an imageless navigation device on surgical time, when compared with standard mechanical guides.Methods:We retrospectively reviewed prospectively collected data from 61 consecutive primary unilateral THA cases (posterior approach) performed by a single surgeon. Procedural time (incision to closure) for THA performed with (intervention) or without (control) a computer-assisted navigation system was compared. In the intervention group, the additional time associated with the use of the device was recorded. Mean times were compared using independent samples t-tests with statistical significance set a priori at p<0.05.Results:There was no statistically significant difference between procedural time in the intervention and control groups (102.3±28.3 mins vs. 99.1±14.7 mins, p=0.60). The installation and use of the navigation device accounted for an average of 2.9 mins (SD: 1.6) per procedure, of which device-related setup performed prior to skin incision accounted for 1.1 mins (SD: 1.1) and intra-operative tasks accounted for 1.6 mins (SD: 1.2).Conclusion:In this series of 61 consecutive THAs performed by a single surgeon, the set-up and hands-on utilization of a novel surgical navigation tool required an additional 2.9 minutes per case. We suggest that the intraoperative benefits of this novel computer-assisted navigation platform outweigh the minimal operative time spent using this technology.
Highlights
Accurate acetabular component placement during Total Hip Arthroplasty (THA) is essential to minimize bearing1874-3250/18 2018 Bentham Open390 The Open Orthopaedics Journal, 2018, Volume 12 wear, noise generation, and post-operative complications such as instability and iliopsoas impingement [1 - 3]
Computer-assisted navigation has proven effective at improving the accuracy of component placement during Total Hip Arthroplasty (THA); the material costs, line-of-site issues and potential for significant time increases have limited their widespread use
The installation and use of the navigation device accounted for an average of 2.9 mins (SD: 1.6) per procedure, of which device-related setup performed prior to skin incision accounted for 1.1 mins (SD: 1.1) and intra-operative tasks accounted for 1.6 mins (SD: 1.2). In this series of 61 consecutive THAs performed by a single surgeon, the set-up and hands-on utilization of a novel surgical navigation tool required an additional 2.9 minutes per case
Summary
Accurate acetabular component placement during Total Hip Arthroplasty (THA) is essential to minimize bearing1874-3250/18 2018 Bentham Open390 The Open Orthopaedics Journal, 2018, Volume 12 wear, noise generation, and post-operative complications such as instability and iliopsoas impingement [1 - 3]. Instability, increased wear and persistent pain secondary to component malposition may lead to decreased patient satisfaction, readmission, reoperation and an increased financial burden on the healthcare system [2 - 4]. As the number of primary THAs continues to increase around the world, health care systems are implementing standard of care perioperative protocols to minimize complications leading to revision surgery. The cost of revision arthroplasty is high and ranges from $29,000 to $54,000 per procedure in the United States [4, 5] and any increase in the number of preventable revision surgeries places even further economic burden on an already strained healthcare system. Computer-assisted navigation has proven effective at improving the accuracy of component placement during Total Hip Arthroplasty (THA); the material costs, line-of-site issues and potential for significant time increases have limited their widespread use
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