Augmented Reality for Acetabular Component Placement in Direct Anterior Total Hip Arthroplasty.

Autor: Alexander C; Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD., Loeb AE; Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD., Fotouhi J; Department of Computer Science, The Johns Hopkins University, Baltimore, MD., Navab N; Department of Computer Science, The Johns Hopkins University, Baltimore, MD., Armand M; Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD; Department of Mechanical Engineering, The Johns Hopkins University, Baltimore, MD., Khanuja HS; Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD.
Jazyk: angličtina
Zdroj: The Journal of arthroplasty [J Arthroplasty] 2020 Jun; Vol. 35 (6), pp. 1636-1641.e3. Date of Electronic Publication: 2020 Jan 21.
DOI: 10.1016/j.arth.2020.01.025
Abstrakt: Background: Malposition of the acetabular component of a hip prosthesis can lead to poor outcomes. Traditional placement with fluoroscopic guidance results in a 35% malpositioning rate. We compared the (1) accuracy and precision of component placement, (2) procedure time, (3) radiation dose, and (4) usability of a novel 3-dimensional augmented reality (AR) guidance system vs standard fluoroscopic guidance for acetabular component placement.
Methods: We simulated component placement using a radiopaque foam pelvis. Cone-beam computed tomographic data and optical data from a red-green-blue-depth camera were coregistered to create the AR environment. Eight orthopedic surgery trainees completed component placement using both methods. We measured component position (inclination, anteversion), procedure time, radiation dose, and usability (System Usability Scale score, Surgical Task Load Index value). Alpha = .05.
Results: Compared with fluoroscopic technique, AR technique was significantly more accurate for achieving target inclination (P = .01) and anteversion (P = .02) and more precise for achieving target anteversion (P < .01). AR technique was faster (mean ± standard deviation, 1.8 ± 0.25 vs 3.9 ± 1.6 minute; P < .01), and participants rated it as significantly easier to use according to both scales (P < .05). Radiation dose was not significantly different between techniques (P = .48).
Conclusion: A novel 3-dimensional AR guidance system produced more accurate inclination and anteversion and more precise anteversion in the placement of the acetabular component of a hip prosthesis. AR guidance was faster and easier to use than standard fluoroscopic guidance and did not involve greater radiation dose.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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