Inclination Error Research Articles

Accelerometer-based portable navigation system shows no superior accuracy over pelvic alignment guide for acetabular cup placement in total hip arthroplasty in lateral decubitus position.

Total hip arthroplasty (THA) using a portable navigation system (PNS) incurs costs per procedure. However, it does not require a large console. This study aimed to compare the accuracy of acetabular cup placement using a pelvic alignment guide (PAG) attached to the pelvis and an accelerometer-based PNS in THA performed in the lateral decubitus position. We retrospectively analyzed 100 hips that underwent primary THA in the lateral decubitus position between July 2018 and January 2021. The PAG was used in 50 hips, whereas the PNS was used in the other 50. Cup placement accuracy was measured using postoperative computed tomography scans, comparing errors in inclination and anteversion angles. The surgical time, blood loss, and complications were recorded. The follow-up period was at least 2 years in all cases. The mean absolute error of the inclination angle was similar between the groups (the PAG group: 3.7° ± 2.3° [range, 0.0-9.0]; the PNS group: 3.7° ± 2.3° [range, 0.2-10.5], p = 0.705). The mean absolute error of the anteversion angle was significantly smaller in the PAG group than in the PNS group (3.0° ± 2.4° [range, 0.0-9.7] vs. 6.5° ± 4.8° [range, 0.3-17.3], p < 0.001). The PAG group had a higher proportion of hips within 5° and 10° of the target angle (64 vs. 42%, P = 0.028, and 100 vs. 74%, p < 0.001, respectively). The PNS group had six hips with anteversion errors of 15° or more. Surgical time and blood loss were lower in the PAG group. The PNS group had one dislocation, whereas the PAG group did not. The accelerometer-based PNS did not demonstrate superior cup alignment accuracy compared to the PAG in THA performed in the lateral decubitus position. This finding informs surgeons that computer-assisted surgery is not necessarily superior to conventional THA using a PAG.

Design and Testing of a 2-DOF Adaptive Profiling Header for Forage Harvesters

The existing forage harvester header cannot automatically adjust the height and inclination during operation, resulting in uneven stubble height of forage, which, in turn, affects the efficiency of harvesting and the quality of forage regeneration. To address this issue, this study conducted the design and experimentation of a 2-degrees-of-freedom (DOF) profiling header. Firstly, this study designed an adaptive profiling header with 2-DOF adjustment, which was realized by the height adjustment mechanism and the tilt angle adjustment mechanism. The relationship model between the profiling device and the attitude of the header was established so that the header can acquire ground undulation in real time through the angle sensor of the profiling device. In order to verify the rationality of the header design, a co-simulation model of ADAMS and MATLAB/Simulink was built, and the header attitude control system was designed based on the fuzzy PID algorithm. The co-simulation results show that the header height (H) is always kept around 150 mm during the forwarding process of the harvester, with a maximum error of 5.8 mm, and the average relative error (REH) and root mean square error (RMSEH) were 1.4% and 2.6 mm, respectively, and the maximum error of the tilt angle (γ) of the header is 0.53° and the RMSEγ is 0.22°, which indicates that the header profiling mechanism can accurately reflect the undulation of the terrain and the header attitude control system has good robustness. Finally, the test platform was built and tested in a grassland. The test results show that the average height of the header is 149.8 mm, the maximum error is 7.5 mm, and the REH and RMSEH are 3.4% and 5.3 mm, respectively. The average error of the header inclination is 0.34°, and the maximum error is 0.57°. The test results indicate that the header can realize the adaptive adjustment of height and inclination, and the control system has high precision, stability and reliability, meeting the demand of automatic regulation of header attitude of a forage harvester.

An in vitro comparison of mixed-reality navigation to traditional freehand and patient-specific instrumentation techniques for glenoid guide pin insertion during shoulder arthroplasty

BackgroundAccurate insertion of the glenoid guide pin in shoulder arthroplasty (RSA) is important for obtaining optimized glenoid component position and orientation. The objective of this study was to evaluate and compare the accuracy of three glenoid guide pin insertion techniques: 1) traditional software planning using freehand guide pin insertion (freehand), 2) guide pin insertion utilizing patient-specific instrumentation (PSI), and 3) using a mixed reality navigation (MR-NAV) system. MethodsTwenty (20) computer tomography (CT) scans were obtained from patients exhibiting glenoid erosion patterns according to the Walch and Favard classifications. Cases were planned using validated three-dimensional (3D) preoperative planning software. The CT data was then used to 3D print triplicate plastic models of each glenoid to evaluate the three guide pin insertion techniques. The first technique employed traditional software planning with freehand guide pin insertion. The second method used preoperatively planned PSI guides, while the third utilized a MR-NAV system, which provided real-time holographic guidance during guide pin insertion. Once all guide pins had been inserted into the models, an independent optical tracking system and custom digitization device was used to quantify the position and orientation of each guide pin relative to the glenoid. The outcomes for this study included the absolute mean error in guide pin inclination, version, and entry point relative to the preoperative plan. The absolute Total Global Error was also assessed, which was defined as the sum of the absolute guide pin orientation and position error relative to the preoperative plan. ResultsNo statistically significant differences between MR-NAV and PSI were found for the inclination error (2±1° versus 2±1°; P=0.056), version error (1±1° versus 1±1°; P=1.000), and Total Global Error (5±1 [mm+deg] versus 5±1 [mm+deg], P=1.000), respectively. The freehand technique produced significantly greater error than MR-NAV and PSI for inclination (5±3°, P≤0.017), version (4±3°, P≤0.032) and Total Global Error (8±3 [mm+deg], P<0.001). No statistically significant differences in the entry point error were observed between all guide pin insertion methods (P≥0.058). DiscussionThese results demonstrate that the precision and accuracy of MR-NAV is comparable to PSI and superior to a freehand technique for glenoid guide pin insertion in-vitro. Further study is needed to compare the accuracy of these techniques intra-operatively, in addition to assessing a potential learning curve between surgeons of varying experience with the MR-NAV system.

Comparison between accuracy of augmented reality computed tomography-based and portable augmented reality-based navigation systems for cup insertion in total hip arthroplasty

Augmented reality (AR) has been used for navigation during total hip arthroplasty (THA). AR computed tomography (CT)-based navigation systems and AR-based portable navigation systems that use smartphones can also be used. This study compared the accuracy of cup insertion during THA using AR-CT-based and portable AR-based navigation systems. Patients with symptomatic hip disease who underwent primary THA in the supine position using both AR CT-based and portable AR-based navigation systems simultaneously between October 2021 and July 2023 were included. The primary outcome of this study was the absolute difference between cup angles in the intraoperative navigation record and those measured on postoperative CT. The secondary outcome was to determine the factors affecting the absolute value of the navigation error in radiographic inclination (RI) and radiographic anteversion (RA) of the cup, including sex, age, body mass index, left or right side, approach, and preoperative pelvic tilt. This study included 94 consecutive patients. There were 11 men and 83 women, with a mean age of 68 years. The mean absolute errors of RI were 2.7° ± 2.0° in the AR CT-based and 3.3° ± 2.4° in the portable AR-based navigation system. The mean absolute errors of RA were 2.5° ± 2.1° in the AR CT-based navigation system and 2.3° ± 2.2° in the portable AR-based navigation system. No significant differences were observed in RI or RA of the cup between the two navigation systems (RI: p = 0.706; RA: p = 0.329). No significant factors affected the absolute value of the navigation errors in RI and RA. In conclusion, there were no differences in the accuracy of cup insertion between the AR CT-based and portable AR-based navigation systems.

Accuracy of cup placement and pelvic motion in total hip arthroplasty in the lateral decubitus position using a new computed tomography-based navigation system with augmented reality technology.

This study aimed to investigate the accuracy of cup position and assess the changes in pelvic tilt during primary total hip arthroplasty (THA) in the lateral decubitus position using a new computed tomography (CT)-based navigation system with augmented reality (AR) technology. There were 37 cementless THAs performed using a CT-based navigation system with AR technology in the lateral decubitus position and 63 cementless THAs performed using manual implant techniques in the lateral decubitus position in this retrospective study. Postoperative cup radiographic inclination and anteversion were measured using postoperative CT, and the proportion of hips within Lewinnek's safe zone was analyzed and compared between the two groups. The mean absolute values of navigation error were assessed. Intraoperative pelvic tilt angles were also recorded using navigation system. The percentage of cups inside Lewinnek's safe zone was 100% in the navigation group and 35% in the control group (p < 0.001). The mean absolute values of navigation error in inclination and anteversion were 2.9° ± 2.1° and 3.3° ± 2.4°, respectively. The mean abduction angle of the pelvis was 5.1° ± 4.8° after placing the patients in the lateral decubitus position and 4.1° ± 6.0° after cup placement. The mean posterior tilt angle was 6.8° ± 5.1° after placing the patients in the lateral decubitus position and 9.3° ± 5.9° after cup placement. The mean internal rotation angle was 14.8° ± 7.4° after cup placement. There were no correlations between the navigation error in inclination or anteversion and the absolute values of changes of the pelvic tilt angle at any phase. Although progressive pelvic motion occurred in THA in the lateral decubitus position, especially during cup placement, the CT-based navigation system with AR technology improved cup placement accuracy.

Registration in the supine position improve the accuracy of cup placement in total hip arthroplasty using a portable navigation system

Portable navigation systems have been developed for use in total hip arthroplasty (THA) in recent years. Although intraoperative registration in the lateral decubitus position or the supine position is need to create the three-dimensional coordinate system, it is not clear which position is appropriate. The purpose of this study was to assess the accuracy of cup placement in primary THA in the lateral decubitus position using an image-free handheld navigation device with registration in the lateral decubitus or the supine position, and clarify which position is appropriate. This retrospective study included 129 consecutive cementless THAs performed using an image-free handheld navigation device in the lateral decubitus position. Registration in the first 68 hips was performed in the lateral decubitus position and the last 61 hips was performed in the supine position. Postoperative cup radiographic inclination and radiographic anteversion were assessed, and the accuracy was compared between the two groups. The mean absolute errors of the postoperative measured inclination and anteversion from the target angles were 3.9° ± 2.2° and 4.8° ± 3.5° in the lateral group and 2.9° ± 2.7° and 3.2° ± 2.7° in the supine group (p < 0.05). The percentage of cups inside Lewinnek’s safe zone was 94% in the lateral group and 95% in the supine group (ns). The mean absolute values of navigation error in inclination and anteversion were 3.1° ± 2.1° and 4.2° ± 2.8° in the lateral group and 2.3° ± 2.0° and 3.1° ± 2.4° in the supine group (p < 0.05 and p < 0.05). Registration in the supine position improved the accuracy of cup insertion compared with the lateral decubitus position in THA using an image-free handheld navigation device in the lateral decubitus position.

Accuracy comparison of cup positioning during total hip arthroplasty using Hip Align and AR-Hip in the supine position.

The aim of this study is to compare the accuracy of acetabular cup positioning between the accelerometer-based navigation system and the augmented reality-based navigation system during THA in the supine position. This retrospective study included 66 patients (70 hips) who underwent THA using two types of portable navigation system, Hip Align or AR-Hip, in the spine position. The absolute difference between the intraoperative navigation record and postoperative measurement using computed tomography data was evaluated. Preoperative clinical factors that decreased the accuracy of cup positioning by ≥ 3° were analyzed via multiple logistic regression analyses. The average absolute error of inclination was 2.8 ± 2.6° in Hip Align and 2.7 ± 1.8° in AR-Hip, and absolute anteversion error was 2.5 ± 2.0° in Hip Align and 2.6 ± 2.2° in AR-Hip, and there was no significantly different between the two navigation systems. There was a significant association between the absolute measurement error (≥ 3°) of cup inclination and patients' BMI in the Hip Align group [odds ratio (OR) 1.350; 95% confidence interval (CI) 1.035-1.760; p = 0.027], but not in the AR-Hip group. The accuracy of the acetabular cup positioning between the Hip Align and AR-Hip showed no difference during THA in the spine position. The high BMI could have negative influence on the accuracy of cup positioning in THA using Hip Align, thus AR-Hip could be designable for obesity patients.

Glenoid component placement accuracy in total shoulder arthroplasty with preoperative planning and standard instrumentation is not influenced by supero-inferior glenoid erosion.

Accurate glenoid component placement in total shoulder arthroplasty (TSA) remains challenging even with preoperative planning, especially for variable glenoid erosion patterns in the coronal plane. We retrospectively reviewed 170 primary TSAs in which preoperative planning software was used. After registration of intraoperative bony landmarks, surgeons were blinded to the navigation screen and attempted to implement their plan by simulating placement of a central-axis guide pin: 230 screenshots of simulated guide pin placement were included (aTSA = 66, rTSA = 164). Displacement, error in version and inclination, and overall malposition from the preoperatively-planned target point were stratified by the Favard classification describing superior-inferior glenoid wear: E0 (n = 89); E1 (n = 81); E2 (n = 29); E3(n = 29); E4(n = 2). Malposition was considered > 10° for version/inclination errors or > 4mm displacement from the starting point. Mean displacement error was 3.5 ± 2.7mm (aTSA = 2.7 ± 2.3mm, rTSA = 3.8 ± 2.9mm), version error was 5.7 ± 4.7° (aTSA = 5.8 ± 4.4°, rTSA = 5.7 ± 4.8°), inclination error was 7.1 ± 5.6 (aTSA = 4.8 ± 4.8°, rTSA = 8.1 ± 5.7°), and malposition rate was 53% (aTSA = 38%, rTSA = 59%). When compared by Favard classification, there were no differences in any measure; when stratified by TSA type, version error differed for rTSAs (P = .038), with E1 having the greatest version error (6.9 ± 5.2°) and E3 the least (4.2 ± 3.4°). When comparing glenoids without wear (E0) and glenoids with superior wear (E2 and E3), the only difference was greater version error in glenoids without wear (6.0 ± 4.9° vs. 4.6 ± 3.7°, P = .041). Glenoid malposition did not differ based on coronal glenoid morphology. Although, malposition was relatively high, suggesting surgeons should consider alternate techniques beyond preoperative planning and standard instrumentation in TSA. LEVEL OF EVIDENCEIII: Retrospective Cohort Study.

Effects of Tooth Modification in the Involute Helical Gear Form-Grinding Process on Loaded Transmission Character with Consideration of Tooth Axial Inclination Error

Due to the existence of machining and installation errors, axis parallelism error of gear pairs occurs, which causes eccentric load and mesh in-out impact, thus weakening loaded transmission character. To solve this problem, the axis parallelism error of gear pairs was equated with tooth axial inclination error based on the gear-meshing principle. On this basis, we established the tooth modification model with tooth axial inclination error as the variable according to involute helical gear form-grinding process. Then, the degradation of loaded transmission character caused by axis parallelism error of gear pairs was quantitatively analyzed. The gear grinding, gear measuring, and gearbox vibration measuring were, respectively, performed on high-precision CNC horizontal gear form-grinding machine tool L300G, Gleason 350 GMS, and JWY-II multifunctional gearbox loading test bench. The results show that the proposed method can effectively reduce eccentric load and mesh in-out impact and significantly improve loaded transmission character. Therefore, it can provide a theoretical and experimental basis for the research of high-performance gear-grinding technology of gear-grinder machines.

An efficient and accurate force/torque sensing method based on an excitation trajectory

Purpose The purpose of the paper is to propose an efficient and accurate force/torque (F/T) sensing method for the robotic wrist-mounted six-dimensional F/T sensor based on an excitation trajectory. Design/methodology/approach This paper presents an efficient and accurate F/T sensing method based on an excitation trajectory. First, the dynamic identification model is established by comprehensively considering inertial forces/torques, sensor zero-drift values, robot base inclination errors and forces/torques caused by load gravity. Therefore, the sensing accuracy is improved. Then, the excitation trajectory with optimized poses is used for robot following and data acquisition. The data acquisition is not limited by poses and its time can be significantly shortened. Finally, the least squares method is used to identify parameters and sense contact forces/torques. Findings Experiments have been carried out on the self-developed robot manipulator. The results strongly demonstrate that the proposed approach is more efficient and accurate than the existing widely-adopted method. Furthermore, the data acquisition time can be shortened from more than 60 s to 3 s/20 s. Thus, the proposed approach is effective and suitable for fast-paced industrial applications. Originality/value The main contributions of this paper are as follows: the dynamic identification model is established by comprehensively considering inertial forces/torques, sensor zero-drift values, robot base inclination errors and forces/torques caused by load gravity; and the excitation trajectory with optimized poses is used for robot following and data acquisition.

Automatic Measurement of Inclination Angle of Utility Poles Using 2D Image and 3D Point Cloud

The utility pole inclination angle is an important parameter for determining pole health conditions. Without depth information, the angle cannot be estimated from a 2D image, and without large labeled reference pole data, it is time consuming to locate the pole in the 3D point cloud. Therefore, this paper proposes a method that processes the pole data from the 2D image and 3D point cloud to automatically measure the pole inclination angle. Firstly, the mask of the pole skeleton is obtained from an improved Mask R-CNN. Secondly, the pole point cloud is extracted from a PointNet that deals with the generated frustum from the pole skeleton mask and depth map fusion. Finally, the angle is calculated by fitting the central axis of the pole cloud data. ApolloSpace open dataset and laboratory data are used for evaluation. The experimental results show that the AP75 of improved Mask R-CNN is 58.15%, the accuracy of PointNet is 92.4%, the average error of pole inclination is 0.66°, and the variance is 0.12°. It is proved that the method can effectively realize the automatic measurement of pole inclination.

An initial study of interference coloration for quantifying the texture and fabric of ice

The manual application of universal (Rigsby) stage techniques is commonly used to determine the fabric of thin sections of ice viewed with crossed-polarized light. This process can require hours of focus in cold conditions to identify the c-axis of each grain in a thin section. Automated ice texture and fabric methods of several forms exist but are rarely implemented beyond the field of glaciology. The present study introduces a method based on the theory of interference coloration for automated ice texture and quarter fabric analysis by using in-plane conventional photography of an ice thin section as input. The method is compatible with universal stages and polariscopes, and is not restricted by the planar-face dimensions of the thin section, allowing for thin section analysis of any size when sufficient digital camera resolution is available. Light source color temperature and chromatic adaptation are considered in the interference coloration theory, and ice fabrics are simulated for reference in identifying ice types. Sample thin section texture and quarter fabric analyses from freshwater lake and laboratory-grown ice are presented to demonstrate the applications of the method. The method is compared with the Rigsby stage technique, which yielded mean (standard deviation of) azimuth and inclination errors of 2.9 (1.0) and 11.5 (8.0) degrees, respectively, thereby demonstrating accuracy sufficient for quantifying quarter fabrics when considering a mean standard deviation in inclination of 5.4 degrees with the Rigsby stage technique.

Research on Integrated Navigation System of Agricultural Machinery Based on RTK-BDS/INS

To improve the positioning accuracy and reliability of autonomous navigation agricultural machinery and reduce the cost of high-precision positioning, an integrated navigation system based on Real-Time Dynamic Kinematic BeiDou Navigation Satellite System (RTK-BDS) and Inertial Navigation System (INS) is designed in this study. On the one hand, an autonomous navigation control board is designed and made in the system, which integrates BDS high-precision analysis module, Inertial Measurement Unit (IMU) module, and radio module, and realizes the integrated navigation algorithm on the control board. On the other hand, low-cost RTK technology is realized by building differential reference stations and vehicle-mounted mobile stations. Experiments are carried out on actual farm machinery under different road conditions including open road, signal-shielded road, and urban congested road. According to the angular velocity and acceleration information from INS and the position and velocity information from the BDS high-precision analysis module, the system uses Kalman filter algorithm for data fusion to calculate the precise position, velocity, and attitude information of agricultural machinery in real time. The experimental results show that the position error of the integrated navigation system on the open road is within 3 cm, the azimuth error is within 0.6°, and the inclination error is within 1°, all of which converge rapidly when encountering bad road conditions. It can be known from the experimental results that the RTK-BDS/INS integrated navigation system has high positioning accuracy, strong adaptive anti-interference ability, and low implementation cost of RTK technology, which provides a reliable way for automatic navigation control of agricultural machinery.

Preoperative Planning for Anatomic Total Shoulder Arthroplasty.

The success of total shoulder arthroplasty is dependent on both proper patient selection and restoration of the native anatomy. After proper patient selection, preoperative planning is essential to select implants that will allow the surgeon to properly restore soft-tissue tension and correct for deformity. Although it is possible to template implants with plain radiographs, these do not allow accurate measurements of the complex three-dimensional anatomy of the glenohumeral joint. CT can be used to further examine version of the glenoid and humerus, as well as humeral head subluxation. Three-dimensional reconstructions also allow for virtual implantation, resulting in a more reliable prediction of implant appearance. Commercial software is available that calculates parameters such as version; however, these have been shown to have variability when compared with measurements obtained by surgeons. Patient-specific instrumentation can also be obtained based on preoperative measurements; however, although it allowed for improved measurements when compared with two-dimensional imaging, there has been no difference in version error, inclination error, or positional offset of the glenoid implant when comparing patient-specific instrumentation with standard instrumentation. Intraoperative navigation can also be used to give real-time feedback on implant positioning; however, additional studies are needed to fully evaluate its benefit.

Detection and compensation of installation eccentricity of photoelectric encoder based on double highpass filter

As a precision position sensor, the photoelectric encoder has difficulty avoiding eccentricity or tilt error in the industrial manufacturing and assembly process. At present, manual error correction is often used to adjust. The adjustment efficiency is low, and it has difficulty cooperating with other types of error compensation methods. In view of these problems, we proposed a photoelectric encoder eccentricity error detection and compensation method based on digital signal bandpass filtering that effectively corrects the signal deviation caused by the installation eccentricity in the output signal and judges the direction and magnitude of the eccentricity error to realize the encoding correction of eccentricity and inclination error of the device. The mathematical model of the eccentric error generation principle of the photoelectric encoder combined with the Lissajous figure was derived. We then demonstrated the design of a photoelectric encoder error detection platform to detect photoelectric encoders of different diameters in real time. Finally, using the advantages of field programmable gate array high-speed parallel processing, the error compensation algorithm was written into the development chip to improve the efficiency of processing the encoder output error signal. This method can adapt to the eccentricity error correction and compensation of different models of photoelectric encoders and can greatly improve the efficiency and accuracy compared with previous detection methods.

A method combining the use of a mobile application and a dedicated pelvic positioner for acetabular cup insertion

BackgroundWe developed a mobile device application and dedicated pelvic positioner with the aim of improving the acetabular cup placement accuracy in patients undergoing total hip arthroplasty (THA). The function of the application was to display the intra-operative cup angle. The accuracy and clinical usefulness of this combined method were verified through comparison with the conventional alignment guide method.MethodsIn total, 60 patients who underwent cementless THA were included in this study. We compared the cup alignment when using this combined method with that when using the conventional alignment guide method. The absolute value error between the intra- and post-operative angles of inclination and anteversion of the cup was calculated.ResultsThe absolute value error of inclination was 2.4° ± 2.1° in the study group and 4.0° ± 3.3° in the control group (P = 0.107). The absolute value error of anteversion was 2.8° ± 2.6° in the study group and 7.4° ± 5.3° in the control group (P < 0.001).ConclusionUsing the application and pelvic positioner is simple and can be introduced at a low cost. The more accurate measurement of the intra-operative cup angle using this combined method has improved the cup insertion accuracy compared with that of the conventional alignment guide method.

A Comparison of Component Positioning Between Fluoroscopy-Assisted and Robotic-Assisted Total Hip Arthroplasty

BackgroundThis single-surgeon retrospective study examined a consecutive series of direct anterior approach total hip arthroplasties (THAs). Differences for the accuracy of acetabular component placement, leg length discrepancy, femoral offset, and absolute global offset difference were measured for patients who underwent hip replacement surgery with either fluoroscopic or robotic guidance. MethodsOne hundred THAs were included in both the fluoroscopically guided and robotically guided groups in the study. The program TraumaCad was used to analyze the preoperative and 6-week postoperative standing anteroposterior pelvic radiographs used in this study to evaluate the accuracy of component positioning. ResultsRobotic-guided surgery demonstrated a small improvement in acetabular inclination error, 3.8° average robotic error vs 4.63° average fluoroscopic error (P < .01). There was no statistically significant difference in accuracy for acetabular anteversion, leg length discrepancy, femoral offset, or global offset difference between the 2 groups. There was also no significant difference in the placement of acetabular components into the Lewinnek safe zone or Callanan safe zone. Both fluoroscopically guided and robotically guided THA patients had similar patterns of error, with excessive anteversion and inclination being more common than inadequate anteversion or inclination. ConclusionThe findings from our study question the use of haptic robotic guidance during direct anterior approach THA when compared to fluoroscopic guidance.

Influence of glenoid wear pattern on glenoid component placement accuracy in shoulder arthroplasty.

BackgroundAccurate glenoid component placement in shoulder arthroplasty is often difficult even with the use of preoperative planning. Computer navigation and patient-specific guides increase component placement accuracy, but which patients benefit most is unknown. Our purpose was to assess surgeons' accuracy in placing a glenoid component in vivo using 3-dimensional preoperative planning and standard instruments among various glenoid wear patterns.MethodsWe conducted a retrospective review of 170 primary anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA) performed at a single institution. Commercially available preoperative planning software was used in all arthroplasties with multiplanar 2-dimensional computed tomography and a 3-dimensional implant overlay. After registration of intraoperative bony landmarks to the navigation system, participating surgeons with knowledge of the preoperative plan were blinded to the computer screen and attempted to implement their preoperative plan by simulating placement of a central-axis glenoid guide pin. Two hundred thirty-three screenshots of surgeon's simulated guide pin placement were included. Glenoid displacement, error in version and inclination, and overall malposition from the preoperatively planned target point were stratified by posterior wear status (with [Walch B2 or B3] or without [A1, A2, or B1]) and Walch classification (A1, A2, B1, B2, or B3). The glenoid component was considered malpositioned when version or inclination errors exceeded 10° or the starting point displacement exceeded 4 mm.ResultsFor rTSA, errors in version were greater for glenoids with posterior wear compared with those without (8.1° ± 5.6° vs. 4.7° ± 4.0°; P < .001). On post hoc analysis, B2 glenoids had greater version error than A1, A2, and B1 glenoids. A greater proportion of glenoids undergoing rTSA that possessed posterior wear had an error in version >10° compared with those without (31% vs. 8%; P < .001). Consequently, glenoids undergoing rTSA with posterior wear were malpositioned at a greater rate compared with those without (73% vs. 53%). In contrast, glenoids undergoing aTSA with and without posterior wear did not differ based on displacement error, version error, inclination error, or malposition occurrence.ConclusionsPosterior glenoid bone loss more commonly resulted in glenoid version errors exceeding 10 degrees and component malposition in rTSA, but not for aTSA. Malposition was still relatively high in patients without significant posterior wear for both aTSA (36%) and rTSA (53%). Surgeons should consider alternate techniques beyond preoperative planning and standard instrumentation when performing shoulder arthroplasty in patients with posteriorly worn glenoids.

Characterization and Calibration of Measurement Error Associated With Attitude Drift of a Coil Vector Magnetometer

In long-term observations, the attitude drift of a coil vector magnetometer caused by mechanical deformation will directly affect the accuracy of magnetic direction measurements. To solve this problem, we propose a characterization model and calibration method for the measurement error associated with attitude drift. The proposed model uses an attitude matrix to define a mapping from the unmeasurable characteristic angle to the measurable magnetometer attitude. We propose a new <i>dif</i> coordinate system to establish a characterization model linking the characteristic angle of the magnetometer attitude to the measurement error of the magnetic direction, thereby permitting quantitative analysis of the attitude drift and real-time suppression of its negative influence on the measurement accuracy without complex manual operations. The proposed model shows that in the presence of small attitude changes, the measurement error of the magnetic inclination is mainly determined by the south-north non-levelness of magnetometer, and the error of magnetic declination is mainly determined by the magnetometer orientation and east-west non-levelness. Our simulations show that when the east-west non-levelness, south-north non-levelness, and orientation angle of the magnetometer are 232.6&#x2033;, 206.2&#x2033;, and 615.4&#x2033;, respectively, the measurement errors (baseline shift) of the magnetic inclination and declination are 206.9&#x2033; and 364.2&#x2033;, respectively. To verify the results, we designed an experimental platform and conducted a comparative experiment. The results show that in the presence of the aforementioned attitude parameters, the measurement errors of the magnetic inclination and declination can be reduced by 97.8% and 88.6%, respectively, through error calculation and baseline correction.

The accuracy of acetabular cup placement in primary total hip arthroplasty using an image-free navigation system

BackgroundIntraoperative navigation systems have been shown to improve the accuracy of acetabular component insertion in total hip arthroplasty (THA). The purpose of this study was to investigate the accuracy of cup orientation in primary THA using an image-free navigation system.MethodsA total of 107 consecutive cementless THAs using an image-free navigation system were performed from February 2017 to March 2020 (the navigation group). As a control group, 77 retrospective consecutive cases who underwent THAs with manual implant-techniques between February 2012 and April 2017 were included. Postoperative cup radiographic inclination and radiographic anteversion relative to the functional pelvic plane were assessed using a 3D-template system after computed tomography (CT) examination.ResultsThe mean absolute errors of the postoperative measured angles from the target angles in inclination were 3.4° ± 3.0° in the navigation group and 8.4° ± 6.6° in the control group (p < 0.001). The mean absolute errors in anteversion were 5.1° ± 3.6° in the navigation group and 10.8° ± 6.5° in the control group (p < 0.001). The percentage of cups inside the Lewinnek safe zone was 93% in the navigation group and 44% in the control group (p < 0.001). The mean absolute values of navigation error were 3.3° ± 2.8° in inclination and 5.8° ± 4.9° in anteversion. Among the cases of osteoarthritis, the inclination error was significantly higher in Crowe group 2 to 4 than in Crowe group 1 (5.1° ± 3.5° and 3.0° ± 2.5°, respectively, p < 0.05). The percentage of hips with inclination error over 10° in Crowe group 2 to 4 was significantly higher than in Crowe group 1 (17 and 1%, respectively, p < 0.05).ConclusionsThe image-free navigation system improved the accuracy of cup orientation. The accuracy of cup position was less in Crowe group 2 to 4 than in Crowe group 1.