Smartphone-assisted technique in total hip arthroplasty can improve the precision of acetabular cup placement: a randomised controlled trial
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2021;9(5):7 Hip Int. 2021 Jan;31(1):50-57.What this means for my practice?
The results of this study suggest that smartphone-assistance in addition to conventional mechanical alignment guided acetabular component positioning may reduce the number of safe zone outliers compared to mechanical alignment guidance alone in patients undergoing total hip arthroplasty. This study was limited by the use of fluoroscopy for pelvic positioning in the smartphone group only, which may have resulted in biased results, as well as the small sample size which was underpowered to detect differences in dislocation or infection rates. Larger trials are required in the future to further assess the potential role of smartphone technology in total hip arthroplasty.
Resumo do estudo
Sixty-four patients scheduled for a total hip arthroplasty via a posterolateral approach were randomized to receive conventional mechanical alignment guided acetabular component positioning with smartphone-assistance to function as a pelvic tilt goniometer to assess pelvic motion (n=32), or sole conventional mechanical alignment guided acetabular component positioning (n=32). The primary outcome of interest was the incidence of cup placement outside of the Lewinnek safe zone. Secondary outcomes of interest included radiographic measurements of inclination and anteversion angle, deviation from target inclination (40deg) and anteversion (20deg), and the incidence of adverse events. Radiographic assessments were performed 6 weeks post-operation. Study results revealed a statistically significantly lower incidence of safe zone outliers in the smartphone group compared to the conventional group (p=0.008). No statistical differences in inclination angle (p=0.567), anteversion angle (p=0.856), deviation from 40deg inclination (p=0.494), deviation from 20deg anteversion (p=0.643), or incidence of posterior dislocation (p=1.0) were observed between the two groups. Operative time was 14 minutes longer in the smartphone group, however the difference was not statistically significantly different (p=0.069).
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