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General Orthopaedics

COMPARISON OF COMPUTER NAVIGATED VS NON NAVIGATED TECHNIQUES IN LEG LENGTH RESTORATION IN TOTAL HIP ARTHROPLASTY

Computer Assisted Orthopaedic Surgery (CAOS) 13th Annual Meeting of CAOS International



Abstract

INTRODUCTION

Leg length discrepancy following total hip arthroplasty (THA) can be functionally disabling for affected patients and can lead on to litigation issues. Assessment of limb length discrepancy during THA using traditional methods has been shown to produce inconsistent results. The aim of our study was to compare the accuracy of navigated vs. non navigated techniques in limb length restoration in THA.

METHODS

A dataset of 160 consecutive THAs performed by a single surgeon was included. 103 were performed with computer navigation and 57 were non navigated. We calculated limb length discrepancy from pre and post op radiographs. We retrieved the intra-operative computer generated limb length alteration data pertaining to the navigated group. We used independent sample t test and descriptive statistics to analyse the data.

RESULTS

The two subgroups were matched for age, diagnosis and preoperative leg length discrepancy. The mean age was 69.12 (37–89, SD-8.3) and the mean BMI was 29 (19–44, SD-5.03). The mean post op limb length discrepancy in the non navigated group was 5 mm (SD-6) as compared to mean of 3.5mm (SD-6.5) for the computer navigated group. This difference was statistically significant (p<0.04). 18% of patients in the non navigated group had a limb length discrepancy of >10 mm as compared to 12% in the navigated group. There was no statistically significant difference between the computer predicted leg length alterations and those measured on radiographs. (p>0.15)

DISCUSSION & CONCLUSION

The use of Computer navigation in THA can be useful in reducing errors related to leg length discrepancy. It helps in reducing the rates of unacceptably high discrepancies. In our experience, the results of this technique were predictable and reproducible. We intend to continue using this tool for our total hip arthroplasties.


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