Abstract
Utilization of C-arm fluoroscopy during direct anterior total hip arthroplasty (THA) is disruptive and potentially increases the risks of patient infection and cumulative surgeon radiation exposure. This pilot study evaluated changes in surgeon C-arm utilization during an initial 10 cases of direct anterior THA in which an imageless computer-assisted navigation device was introduced. This retrospective study includes data from 20 direct anterior THA cases performed by two orthopaedic surgeons (BC; SRE) in which an imageless computer-assisted navigation device was utilized (Intellijoint HIP®; Intellijoint Surgical, Waterloo, ON, Canada). Total C-arm image count was recorded in each case, and cases were grouped in sets of 5 for each surgeon. The mean C-arm image count was calculated for each surgeon, and combined C-arm image counts were calculated for the study cohort. Student's t-tests were used to assess differences. The use of intraoperative C-arm fluoroscopy decreased from a mean of 9.4 images (standard deviation [SD]: 8.6; Range: 3 – 23) to a mean of 2 images (SD: 2.9; Range: 0 – 7) for surgeon BC (P=0.10) and decreased from a mean of 10.75 images (SD: 1.2; range 9 – 12) to a mean of 6.7 images (SD: 8.3; range: 0 – 16) for surgeon SRE (P=0.36). Combined, an overall decrease in intraoperative C-arm image count from a mean of 11.3 images (SD: 6.9; range: 6 – 23) to a mean of 3.7 images (SD: 3.9; range: 0 – 8.5) was observed in the study cohort (P=0.06). The adoption of imageless computer-assisted navigation in direct anterior THA may reduce the magnitude of intraoperative C-arm fluoroscopy utilization; however further analysis is required.
