Does Augmented Reality-based Portable Navigation Improve the Accuracy of Cup Placement in THA Compared With Accelerometer-based Portable Navigation? A Randomized Controlled Trial.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2024;12(6):2 Clin Orthop Relat Res . 2023 Aug 1;481(8):1515-1523.What this means for my practice?
While the AR-based portable navigation system demonstrated a slight improvement in radiographic anteversion, the clinical significance remains unclear. Pending further studies demonstrating patient-perceivable advantages associated with these small radiographic differences, the authors recommended to exercise caution against widespread use due to added costs with negligible clinical benefit. Of note, the external validity of the study is unclear, as the study was conducted at a single center, and blinding was not possible for some involved parties. Additionally, immediate postoperative radiographs might not accurately reflect cup placement due to potential pelvic tilt during anesthesia.
Study Summary
One hundred and twenty six patients undergoing unilateral total hip arthroplasty (THA) were randomly assigned to receive either an augmented reality (AR) -based portable navigation system (n=62) or an accelerometer-based portable navigation system (n=64) during surgery. The primary outcome was the absolute difference between the cup placement angle shown on the navigation system screen and the angle measured on postoperative radiographs. Secondary outcomes included intraoperative or postoperative complications and were assessed immediately after surgery. The study found no significant difference in radiographic inclination angles between the two groups, but the AR group showed a smaller absolute difference in radiographic anteversion angles compared to the accelerometer group. Given this information, the authors do not recommend widespread use of these systems in clinical practice at this time.
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