Comparison of Clinical Outcomes After Total Hip Arthroplasty with and without Computed Tompgraphy-Based Navigation System for Osteonecrosis of the Femoral Head: a Propensity Score Matched Analysis

3 pages•Published: October 26, 2019

Kazuma Takashima, Takashi Sakai, Hidetoshi Hamada, Wataru Ando, Masaki Takao and Nobuhiko Sugano

Abstract

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 this study. 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 angle was smaller in the navigation group than in the non-navigation group (p < 0.001). Use of the CT- based navigation system (HR; 0.26, 95% CI, 0.07–0.98; p = 0.047) turned out to be the predictor for preventing dislocation. In conclusion, use of the CT-based navigation system provided a precise placement of components, and thus help prevent dislocation in patients with ONFH in the propensity score analysis.

Keyphrases: computed tomography based navigation system, osteonecrosis of the femoral head, propensity score analysis, total hip arthroplasty

In: Patrick Meere and Ferdinando Rodriguez Y Baena (editors). CAOS 2019. The 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery, vol 3, pages 359-361.

Links:	https://easychair.org/publications/paper/PZ4P
	https://doi.org/10.29007/2nrz

BibTeX entry

@inproceedings{CAOS2019:Comparison_Clinical_Outcomes_After,
  author    = {Kazuma Takashima and Takashi Sakai and Hidetoshi Hamada and Wataru Ando and Masaki Takao and Nobuhiko Sugano},
  title     = {Comparison of Clinical Outcomes After Total Hip Arthroplasty with and without Computed Tompgraphy-Based Navigation System for Osteonecrosis of the Femoral Head: a Propensity Score Matched Analysis},
  booktitle = {CAOS 2019. The 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery},
  editor    = {Patrick Meere and Ferdinando Rodriguez Y Baena},
  series    = {EPiC Series in Health Sciences},
  volume    = {3},
  publisher = {EasyChair},
  bibsource = {EasyChair, https://easychair.org},
  issn      = {2398-5305},
  url       = {/publications/paper/PZ4P},
  doi       = {10.29007/2nrz},
  pages     = {359-361},
  year      = {2019}}

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