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The Use of Computer Navigation in Total Hip Arthroplasty Is Associated with a Reduced Rate of Revision for Dislocation: A Study of 6,912 Navigated THA Procedures from the Australian Orthopaedic Association National Joint Replacement Registry.
Agarwal, Sujit; Eckhard, Lukas; Walter, William L; Peng, Andrea; Hatton, Alesha; Donnelly, Bill; de Steiger, Richard.
Afiliação
  • Agarwal S; Australian Institute of Musculo-Skeletal Research, Sydney, New South Wales, Australia.
  • Eckhard L; Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, England.
  • Walter WL; Australian Institute of Musculo-Skeletal Research, Sydney, New South Wales, Australia.
  • Peng A; Department of Orthopaedics and Traumatology, University Medical Center of the Johannes-Gutenberg University Mainz, Mainz, Germany.
  • Hatton A; Institute of Bone and Joint Research, the Kolling Institute, The University of Sydney, and Department of Orthopaedics and Traumatic Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.
  • Donnelly B; South Australian Health and Medical Research Institute, South Adelaide, South Australia, Australia.
  • de Steiger R; South Australian Health and Medical Research Institute, South Adelaide, South Australia, Australia.
J Bone Joint Surg Am ; 103(20): 1900-1905, 2021 10 20.
Article em En | MEDLINE | ID: mdl-34143758
BACKGROUND: The use of computer navigation has been shown to produce more accurate cup positioning when compared with non-navigated total hip arthroplasty (THA), but so far there is only limited evidence to show its effect on clinical outcomes. The present study analyzed data from the Australian Orthopaedic Association National Joint Replacement Registry to assess the impact of computer navigation on the rates of all-cause revision and revision for dislocation following THA. METHODS: Data for all non-navigated and navigated primary THAs performed for osteoarthritis in Australia from January 1, 2009, to December 31, 2019, were examined to assess the rate of revision. We analyzed the effects of navigation on rate, reason, and type of revision. Hazard ratios (HRs) from Cox proportional hazard models, adjusted for age, sex, and head size, were utilized. Because of known prosthesis-specific differences in outcomes, we performed a further analysis of the 5 acetabular and femoral component combinations most commonly used with navigation. RESULTS: Computer navigation was utilized in 6,912 primary THAs for osteoarthritis, with the use of navigation increasing from 1.9% in 2009 to 4.4% of all primary THAs performed in 2019. There was no difference in the rate of all-cause revision between navigated and non-navigated THAs looking at the entire group. There was a lower rate of revision for dislocation in the navigation THA cohort. The cumulative percent revision for dislocation at 10 years was 0.4% (95% confidence interval [CI], 0.2% to 0.6%) for navigated compared with 0.8% (95% CI, 0.8% to 0.9%) for non-navigated THAs (HR adjusted for age, sex, and head size, 0.46; 95% CI, 0.29 to 0.74; p = 0.002). In the 5 component combinations most commonly used with navigation, the rate of all-cause revision was significantly lower when these components were navigated compared with non-navigated. The cumulative percent revision at 10 years for these 5 prostheses combined was 2.4% (95% CI, 1.6% to 3.4%) for navigated compared with 4.2% (95% CI, 4.0% to 4.5%) for non-navigated THAs (HR, 0.64; 95% CI, 0.48 to 0.86; p = 0.003). CONCLUSIONS: This study showed that the use of computer navigation was associated with a reduced rate of revision for dislocation following THA. Furthermore, in the component combinations most commonly used with navigation there was also a reduction in the rate of all-cause revision. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Osteoartrite do Quadril / Artroplastia de Quadril / Cirurgia Assistida por Computador / Luxação do Quadril Tipo de estudo: Etiology_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Bone Joint Surg Am Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Osteoartrite do Quadril / Artroplastia de Quadril / Cirurgia Assistida por Computador / Luxação do Quadril Tipo de estudo: Etiology_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Bone Joint Surg Am Ano de publicação: 2021 Tipo de documento: Article