Smartphone Improves Accuracy of Alignment Guide for Acetabular Cup Positioning: a Study in Plastic Bone Model

Main Article Content

Hemmaraj Sukapan

Abstract

Background: Total hip arthroplasty requires accuracy of acetabular cup positioning. Traditional acetabular alignment guide is mostly relied on surgeon’s perception and probably cause error. Use of smartphone with angle measurement application may increase its accuracy.
Objective: To determine the accuracy of acetabular cup positioning with 2 types of alignment guides (X-bar and double bar), comparing between alignment guide alone and combined with smartphone.
Material and method: The pelvis plastic model was fixed to the x-ray table in lateral position. Ten surgeons placed acetabular cups at the target angle of operative inclination 45° and anteversion 20° by using 2 types of alignment guides. Thereafter, the cups were placed by using alignment guide combined with smartphone. Standard AP radiographs were taken and each surgeon repeated cup placement 5 times per tecnnique. Radiographic inclination and anteversion were measured by using PACS program. Comparison between each techniques were analyzed by t-test and Wilcoxon’s rank sum test.
Results: The cups positioned by alignment guide alone had more inclination than by using with smartphone significantly in both X-bar type [47.5° (SD 1.5°) vs 44.9° (SD 0.6°), p<0.001] and double bar type [46.3° (SD 1.4°) vs 45.6 °(SD 1.0°), p=0.004]. They also had less anteversion in X-bar type [10.6° (SD 2.0°) vs 12.6° (SD 2.6°), p<0.001] and double bar type [9.3° (SD 1.7°) vs 10.1° (SD 2.5°), p=0.208]. Using alignment guide combined with smartphone yielded cup position in less inclination in X-bar type (p=0.001) and more anteversion in double bar type (p<0.001).
Conclusion: Smartphone improved the accuracy of alignment guide for positioning acetabular cup by significantly reduced error of radiographic inclination and anteversion. Using with the X-bar alignment guide was more accurate than the double bar guide.

Article Details

How to Cite
Sukapan, H. (2022). Smartphone Improves Accuracy of Alignment Guide for Acetabular Cup Positioning: a Study in Plastic Bone Model. Lampang Medical Journal, 35(2), 56–67. Retrieved from https://he01.tci-thaijo.org/index.php/LMJ/article/view/259755
Section
Original Article

References

Paterno SA, Lachiewicz PF, Kelley SS. The influence of patient-related factors and the position of the acetabular component on the rate of dislocation after total hip replacement. J Bone Joint Surg Am 1997;79:1202-10.

Del Schutte H Jr, Lipman AJ, Bannar SM, Livermore JT, Ilstrup D, Morrey BF. Effects of acetabular abduction on cup wear rates in total hip arthroplasty. J Arthroplasty 1998;13:621-6.

Kennedy JG, Rogers WB, Soffe KE, Sullivan RJ, Griffen DG, Sheehan LJ. Effect of acetabular component orientation on recurrent dislocation, pelvic osteolysis, polyethylene wear, and component migration. J Arthroplasty 1998;13:530-4.

Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am 1978;60(2):217-20.

Callanan MC, Jarrett B, Bragdon CR, Zurakowski D, Rubash HE, Freiberg AA, et al. The John Charnley Award: risk factors for cup malpositioning: quality improvement through a joint registry at a tertiary hospital. Clin Orthop Relat Res 2011;469(2):319-29.

Minoda Y, Ohzono K, Aihara M, Umeda N, Tomita M, Hayakawa K. Are acetabular component alignment guides for total hip arthroplasty accurate?. J Arthroplasty 2010;25(6):986-9.

Jolles BM, Genoud P, Hoffmeyer P. Computer-assisted cup placement techniques in total hip arthroplasty improve accuracy of placement. Clin Orthop Relat Res 2004;426:174-9.

Hassan DM, Johnston GH, Dust WN, Watson G, Dolovich AT. Accuracy of intraoperative assessment of acetabular prosthesis placement. J Arthroplasty 1998;13(1):80-4.

Murray DW. The definition and measurement of acetabular orientation. J Bone Joint Surg Br 1993;75(2):228-32.

Digioia III AM, Jaramaz B, Plakseychuk AY, Moody JE Jr, Nikou C, Labarca RS, et al. Comparison of a mechanical acetabular alignment guide with computer placement of the socket. J Arthroplasty 2002;17:359-64.

Vendittoli PA, Duval N, Stitson DJ, Mâsse B. Vertical acetabular positioning with an inclinometer in total hip arthroplasty. J Arthroplasty 2002;17(7):936-41.

Peters FM, Greeff R, Goldstein N, Frey CT. Improving acetabular cup orientation in total hip arthroplasty by using smartphone technology. J Arthroplasty 2012;27(7):1324-30.

Kanoh T, Hasegawa Y, Masui T, Yamaguchi J, Kawabe K, Ishiguro N. Accurate acetabular component orientation after total hip arthroplasty using an acetabular alignment guide. J Arthroplasty 2010;25(1):81-6.