Digital Fluoroscopic Navigation for Limb Length Restoration During Anterior Total Hip Arthroplasty

Robert O'Leary; Anshul Saxena; William Arguelles; Yvette Hernandez; Chukwuemeka Osondu; Juan Suarez

Digital Fluoroscopic Navigation for Limb Length Restoration During Anterior Total Hip Arthroplasty

Robert O'Leary, Anshul Saxena, William Arguelles, Yvette Hernandez, Chukwuemeka Osondu, Juan Suarez

Research output: Contribution to journal › Article › peer-review

Abstract

<p> <h3 id="x-x-x-x-x-sectitle0015"> Background </h3> <p id="x-x-x-x-x-abspara0010"> Restoration of limb length is important in total <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/hip-arthroplasty" title="Learn more about hip arthroplasty from ScienceDirect's AI-generated Topic Pages"> hip arthroplasty </a> . Clinical evaluation and preoperative templating establish the intended lengthening. The purpose of this study was to assess whether digital fluoroscopic navigation (DF) improved the accuracy of planned lengthening in direct anterior approach total hip arthroplasty (DAA-THA). <h3 id="x-x-x-x-x-sectitle0020"> Methods </h3> <p id="x-x-x-x-x-abspara0015"> Planned lengthening measurements on 100 consecutive unilateral DAA-THA patients, along with patient characteristics, were prospectively collected by 2 surgeons. One surgeon utilized DF to achieve intended length (n = 50), while the other utilized unaided standard <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/fluoroscopy" title="Learn more about fluoroscopy from ScienceDirect's AI-generated Topic Pages"> fluoroscopy </a> (SF; n = 50). A third surgeon blinded to the procedures assessed actual limb length using an ipsilateral overlay technique on the 6-week postoperative radiograph. The difference between the mean planned and actual limb lengthening stratified by DF and SF was assessed using bivariate and multivariate statistics. <h3 id="x-x-x-x-x-sectitle0025"> Results </h3> <p id="x-x-x-x-x-abspara0020"> The mean (standard deviation) planned lengthening in DF and SF groups was 3.96 (2.1) and 3.47 (2.2) mm, respectively. The mean (standard deviation) actual lengthening in DF and SF groups was 3.11 (4.0) and 0.68 (4.6) mm, respectively. After accounting for age, sex, <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/body-mass-index" title="Learn more about body mass index from ScienceDirect's AI-generated Topic Pages"> body mass index </a> , laterality, and the Bone Index, multivariate regression results showed that the average difference between planned and actual limb lengthening in the DF group was significantly lower than that in the SF group ( <em> β </em> = −1.92; 95% confidence interval: −3.51, −0.33; <em> P </em> < .02). A greater percentage of patients in the DF group (66% vs 40%) were within 3 mm of the intended plan ( <em> P </em> < .01). <h3 id="x-x-x-x-x-sectitle0030"> Conclusions </h3> <p id="x-x-x-x-x-abspara0025"> Fluoroscopy helps achieve the intended surgical lengthening in DAA-THA. The use of DF resulted in more accurate execution of lengthening. </p> </p> </p> </p></p>

Original language	American English
Journal	Default journal
Volume	18
State	Published - Dec 1 2022

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@article{0feccaa1fd4a452a913d1428c6c560f5,

title = "Digital Fluoroscopic Navigation for Limb Length Restoration During Anterior Total Hip Arthroplasty",

abstract = " Background Restoration of limb length is important in total hip arthroplasty . Clinical evaluation and preoperative templating establish the intended lengthening. The purpose of this study was to assess whether digital fluoroscopic navigation (DF) improved the accuracy of planned lengthening in direct anterior approach total hip arthroplasty (DAA-THA). Methods Planned lengthening measurements on 100 consecutive unilateral DAA-THA patients, along with patient characteristics, were prospectively collected by 2 surgeons. One surgeon utilized DF to achieve intended length (n = 50), while the other utilized unaided standard fluoroscopy (SF; n = 50). A third surgeon blinded to the procedures assessed actual limb length using an ipsilateral overlay technique on the 6-week postoperative radiograph. The difference between the mean planned and actual limb lengthening stratified by DF and SF was assessed using bivariate and multivariate statistics. Results The mean (standard deviation) planned lengthening in DF and SF groups was 3.96 (2.1) and 3.47 (2.2) mm, respectively. The mean (standard deviation) actual lengthening in DF and SF groups was 3.11 (4.0) and 0.68 (4.6) mm, respectively. After accounting for age, sex, body mass index , laterality, and the Bone Index, multivariate regression results showed that the average difference between planned and actual limb lengthening in the DF group was significantly lower than that in the SF group ( \β = \−1.92; 95\% confidence interval: \−3.51, \−0.33; P < .02). A greater percentage of patients in the DF group (66\% vs 40\%) were within 3 mm of the intended plan ( P < .01). Conclusions Fluoroscopy helps achieve the intended surgical lengthening in DAA-THA. The use of DF resulted in more accurate execution of lengthening. ",

author = "Robert O'Leary and Anshul Saxena and William Arguelles and Yvette Hernandez and Chukwuemeka Osondu and Juan Suarez",

year = "2022",

month = dec,

day = "1",

language = "American English",

volume = "18",

journal = "Default journal",

}

TY - JOUR

T1 - Digital Fluoroscopic Navigation for Limb Length Restoration During Anterior Total Hip Arthroplasty

AU - O'Leary, Robert

AU - Saxena, Anshul

AU - Arguelles, William

AU - Hernandez, Yvette

AU - Osondu, Chukwuemeka

AU - Suarez, Juan

PY - 2022/12/1

Y1 - 2022/12/1

N2 - Background Restoration of limb length is important in total hip arthroplasty . Clinical evaluation and preoperative templating establish the intended lengthening. The purpose of this study was to assess whether digital fluoroscopic navigation (DF) improved the accuracy of planned lengthening in direct anterior approach total hip arthroplasty (DAA-THA). Methods Planned lengthening measurements on 100 consecutive unilateral DAA-THA patients, along with patient characteristics, were prospectively collected by 2 surgeons. One surgeon utilized DF to achieve intended length (n = 50), while the other utilized unaided standard fluoroscopy (SF; n = 50). A third surgeon blinded to the procedures assessed actual limb length using an ipsilateral overlay technique on the 6-week postoperative radiograph. The difference between the mean planned and actual limb lengthening stratified by DF and SF was assessed using bivariate and multivariate statistics. Results The mean (standard deviation) planned lengthening in DF and SF groups was 3.96 (2.1) and 3.47 (2.2) mm, respectively. The mean (standard deviation) actual lengthening in DF and SF groups was 3.11 (4.0) and 0.68 (4.6) mm, respectively. After accounting for age, sex, body mass index , laterality, and the Bone Index, multivariate regression results showed that the average difference between planned and actual limb lengthening in the DF group was significantly lower than that in the SF group ( β = −1.92; 95% confidence interval: −3.51, −0.33; P < .02). A greater percentage of patients in the DF group (66% vs 40%) were within 3 mm of the intended plan ( P < .01). Conclusions Fluoroscopy helps achieve the intended surgical lengthening in DAA-THA. The use of DF resulted in more accurate execution of lengthening.

AB - Background Restoration of limb length is important in total hip arthroplasty . Clinical evaluation and preoperative templating establish the intended lengthening. The purpose of this study was to assess whether digital fluoroscopic navigation (DF) improved the accuracy of planned lengthening in direct anterior approach total hip arthroplasty (DAA-THA). Methods Planned lengthening measurements on 100 consecutive unilateral DAA-THA patients, along with patient characteristics, were prospectively collected by 2 surgeons. One surgeon utilized DF to achieve intended length (n = 50), while the other utilized unaided standard fluoroscopy (SF; n = 50). A third surgeon blinded to the procedures assessed actual limb length using an ipsilateral overlay technique on the 6-week postoperative radiograph. The difference between the mean planned and actual limb lengthening stratified by DF and SF was assessed using bivariate and multivariate statistics. Results The mean (standard deviation) planned lengthening in DF and SF groups was 3.96 (2.1) and 3.47 (2.2) mm, respectively. The mean (standard deviation) actual lengthening in DF and SF groups was 3.11 (4.0) and 0.68 (4.6) mm, respectively. After accounting for age, sex, body mass index , laterality, and the Bone Index, multivariate regression results showed that the average difference between planned and actual limb lengthening in the DF group was significantly lower than that in the SF group ( β = −1.92; 95% confidence interval: −3.51, −0.33; P < .02). A greater percentage of patients in the DF group (66% vs 40%) were within 3 mm of the intended plan ( P < .01). Conclusions Fluoroscopy helps achieve the intended surgical lengthening in DAA-THA. The use of DF resulted in more accurate execution of lengthening.

UR - https://scholarlycommons.baptisthealth.net/se-all-publications/4568

M3 - Article

VL - 18

JO - Default journal

JF - Default journal

ER -

Digital Fluoroscopic Navigation for Limb Length Restoration During Anterior Total Hip Arthroplasty

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