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Link
http://www.ncbi.nlm.nih.gov/pubmed/18676940
2008
Seyler TM,
Lai LP,
Sprinkle DI,
Ward WG,
Jinnah RH.
Department of Orthopaedic Surgery, Wake Forest
University School of Medicine, Medical Center Boulevard, Winston-Salem, NC
27157-1070, USA.
BACKGROUND: Hip resurfacing is a technically demanding
procedure in which accurate positioning of the femoral component is critical
to the avoidance of early implant failures. The purpose of this study was to
assess the accuracy of computer-assisted placement of the femoral component
and to evaluate the impact of computer-assisted surgery on the learning
curve associated with this procedure.
METHODS: The accuracy of positioning
the femoral component was analyzed radiographically in hips undergoing
resurfacing procedures performed by surgeons assigned to four different
study groups: Group 1, in which the operations were performed with use of
computer-assisted surgery by a fellowship-trained surgeon who was
experienced in performing resurfacing arthroplasty (surgical experience,
more than 250 hip resurfacings); Group 2, in which the operations were
performed with use of computer-assisted surgery by senior residents who were
inexperienced in performing resurfacing arthroplasty and who were closely
supervised by faculty; Group 3, in which the operations were performed with
use of conventional instruments by fellowship-trained faculty members; and
Group 4, in which the operations were performed with use of
computer-assisted surgery by a lesser experienced fellowship-trained faculty
member (surgical experience, more than forty but less than seventy-five hip
resurfacings) from Group 3.
RESULTS: The range of error in varus or valgus
angulation that was observed for navigated procedures was 6 degrees in Group
1, 7 degrees in Group 2, and 5 degrees in Group 4. Compared with the
preoperative neck-shaft angle value, the mean postoperative stem-shaft angle
value increased by a mean of 4.7 degrees in Group 1, 7.2 degrees in Group 2,
6.5 degrees in Group 3, and 11.6 degrees in Group 4. When compared with the
use of standard instrumentation, the use of computer-assisted surgery
reduced the number of outliers and facilitated valgus insertion.
CONCLUSIONS: In the present study, computer-assisted surgery resulted in
improved accuracy and precision in positioning the femoral component. In
addition, computer-assisted surgery led to a reduction in the length of the
learning curve for beginners in hip resurfacing and improved the surgeon's
ability to perform this procedure safely.
PMID: 18676940 [PubMed - indexed for MEDLINE]
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