Accuracy of acetabular cup placement in total hip arthroplasty using an augmented reality navigation “pin-less” system: A pilot study

Tetsuya Kimura , Tatsuya Tamaki , Hiroyuki Ogawa
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Abstract

Purpose

Currently, there is limited information regarding the utilization of pin-less augmented reality (AR) assistance in total hip arthroplasty (THA). This preliminary study aimed to evaluate the precision of acetabular cup placement in THA utilizing the AR Navigation “Pin-less” System (Pin-less AR navigation, prototype).

Methods

A total of 72 consecutive primary THAs in 58 patients were categorized into two groups: the Pin-less AR navigation group and the conventional group. All THAs were conducted via the direct anterior approach. First, the absolute value of difference between the intra-operative and post-operative angles (absolute difference) was calculated in the Pin-less AR navigation group. Second, the absolute value of error between the post-operative angles and the target angles (absolute target error) was assessed both in the Pin-less AR navigation group and the conventional group.

Results

The absolute difference in inclination and anteversion angles was 2.2 ​± ​1.4° and 2.4 ​± ​1.5°, respectively. The absolute target error in the Pin-less AR navigation group versus the conventional group was 1.9 ​± ​1.5° versus 4.2 ​± ​2.7° in inclination (P ​< ​0.001) and 2.3 ​± ​1.5° versus 3.1 ​± ​2.1° in anteversion (P ​= ​0.092). The percentage of acetabular cups placed within ±5° from the target angles was significantly higher in the Pin-less AR navigation group (90.3%) compared with the conventional group (52.6%) (P ​< ​0.001).

Conclusions

This study demonstrates that Pin-less AR navigation yielded generally accurate acetabular cup positioning, surpassing the conventional method. Further research is warranted to thoroughly evaluate Pin-less AR navigation.

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使用增强现实导航 "无针 "系统进行全髋关节置换术中髋臼杯置入的准确性:试点研究
目的目前,有关在全髋关节置换术(THA)中使用无针增强现实(AR)辅助的信息非常有限。本初步研究旨在评估在全髋关节置换术中使用 "无针 "AR 导航系统(Pin-less AR navigation,原型)进行髋臼杯置放的精确度。方法将 58 名患者的 72 例连续全髋关节置换术分为两组:无针 AR 导航组和传统组。所有 THAs 均通过直接前路进行。首先,计算无针孔 AR 导航组术中和术后角度差的绝对值(绝对差)。其次,评估了无针孔 AR 导航组和传统组术后角度与目标角度之间误差的绝对值(绝对目标误差)。结果 倾角和前内翻角度的绝对差值分别为 2.2 ± 1.4° 和 2.4 ± 1.5°。无针 AR 导航组与传统组的绝对目标误差分别为:倾斜 1.9 ± 1.5° 对 4.2 ± 2.7°(P < 0.001),内翻 2.3 ± 1.5° 对 3.1 ± 2.1°(P = 0.092)。与传统方法组(52.6%)相比,无针孔 AR 导航组(90.3%)放置的髋臼杯与目标角度的距离在 ±5° 以内的比例明显更高(P < 0.001)。有必要开展进一步研究,对无针式 AR 导航进行全面评估。
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