Rigid Patient Positioning is Unreliable in Total Hip Arthroplasty.

Background: To our knowledge, no study has assessed the ability of rigid patient positioning devices to afford arthroplasty surgeons with ideal acetabular orientation throughout surgery. The purpose of this study is to use robotic arm-assisted computer navigation to assess the reliability of pelvic...

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Publicado en:Journal of Arthroplasty Vol. 32; no. 6; pp. 1890 - 1894
Autores principales: Milone, Michael T., Schwarzkopf, Ran, Meere, Patrick A., Carroll, Kaitlin M., Jerabek, Seth A., Vigdorchik, Jonathan
Formato: clinical trial research Journal Article
Publicado: Churchill Livingstone, Inc. Jun2017
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2017
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      pub: Churchill Livingstone, Inc.
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        10.1016/j.arth.2016.12.038
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        atl: Rigid Patient Positioning is Unreliable in Total Hip Arthroplasty.
      aug:
        au:
          Milone, Michael T.
          Schwarzkopf, Ran
          Meere, Patrick A.
          Carroll, Kaitlin M.
          Jerabek, Seth A.
          Vigdorchik, Jonathan
        affil: Department of Orthopedic Surgery, NYU Langone Orthopaedics, Hospital for Joint Diseases, New York, New York
      sug:
        subj:
          Surgery, Computer-Assisted Methods
          Joint Prosthesis
          Patient Positioning
          Arthroplasty, Replacement, Hip Methods
          Robotics
          Tomography, X-Ray Computed
          Male
          Aged
          Human
          Prospective Studies
          Female
          Young Adult
          Adult
          Middle Age
          Body Regions
          Acetabulum Surgery
          Reproducibility of Results
          Clinical Trials
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Aged: 65+ years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Background: To our knowledge, no study has assessed the ability of rigid patient positioning devices to afford arthroplasty surgeons with ideal acetabular orientation throughout surgery. The purpose of this study is to use robotic arm-assisted computer navigation to assess the reliability of pelvic position in total hip arthroplasty performed on patients positioned with rigid positioning devices.Methods: A prospective cohort of 100 hips (94 patients) underwent robotic-guided total hip arthroplasty in the lateral decubitus position from the posterior approach, 77 stabilized by universal lateral positioner, and 23 by peg board. Before reaming, computed tomography-templated computer software generated true values of pelvic anteversion and inclination based on the position of the robot arm registered to the patient's preoperative pelvic computed tomography.Results: Mean alteration in anteversion and inclination values was 1.7° (absolute value, 5.3°; range, -20° to 20°) and 1.6° (absolute value, 2.6°; range, -8° to 10°), respectively. And 22% of anteversion values were altered by >10° and 41% by >5°. There was no difference between hip positioners used (P = .36). Anteversion variability was correlated with body mass index (P = .02).Conclusion: Despite the use of rigid patient positioning devices-a lateral hip positioner or peg board-this study reveals clinically important malposition of the pelvis in many cases, especially with regard to anteversion. These results show a clear need to pay particular attention to anatomic landmarks or computer-assisted techniques to assure accurate acetabular cup positioning. Patient positioning should not be solely trusted.
      pubtype: Academic Journal
      doctype:
        clinical trial
        research
        Journal Article
      ougenre: Article
    language: English
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