Abstract
Introduction
Past research has focused on complications of bony fixation of navigation reference frames such as fractures and cutting errors.
Objective
This study investigates the consequences of the use of iliac crest percutaneous navigational array pins in terms of pain, irritability and the impact on quality of life.
Method
A prospective, consecutive series of 30 patients presenting for navigated total hip arthroplasty were included in the study. In all patients two temporary 125 × 4 mm Schanz screws were inserted into the iliac crest for the attachment of a navigational reference array. Patients were followed up by telephone at six weeks and three months post-operatively. Patients were also questioned regarding pain, interference with daily activities, pain or discomfort with clothing, how often the wound was noticed and how much time passed before the pain from the site went away completely.
Results
All patients had a pre-operative pain score of 0 for the iliac crest region. Overall, a total of 17 patients (57%) reported pain from the pin-site at least once in the post-operative period. In these patients who reported pain, it lasted a mean of 30 ± 31 days (range, 4 to 122 days).
The proportion of patients describing pain from the puncture site decreased steadily during the post-operative period from 30% at 3 weeks to 10% at 6 weeks and 4% (1 patient) at 3 months. A total of 9 patients (30%) described discomfort or pain at the pin-site irritated by wearing close-fitting clothing or a belt. The wound was not noticed at all by the majority of patients (80%) by 3-months post-operatively.
Conclusion
The use of navigational pins for array fixation often causes pain and irritability for the patient, however this largely resolves in the short-term. This study suggests the incision for pin insertion be made more posteriorly along the iliac crest to reduce the likelihood of irritation with clothing.
