Abstract
In this paper we propose a new system that allows reliable acetabular cup placement when the THA is operated in lateral approach. Conceptually it combines the accuracy of computer-generated patient-specific morphology information with an easy-to-use mechanical guide, which effectively uses natural gravity as the angular reference. The former is achieved by using a statistical shape model-based 2D-3D reconstruction technique that can generate a scaled, patient-specific 3D shape model of the pelvis from a single conventional anteroposterior (AP) pelvic X-ray radiograph. The reconstructed 3D shape model facilitates a reliable and accurate co-registration of the mechanical guide with the patient’s anatomy in the operating theater. We validated the accuracy of our system by conducting experiments on placing seven cups to four pelvises with different morphologies. Taking the measurements from an image-free navigation system as the ground truth, our system showed an average accuracy of 2.1 ±0.7o for inclination and an average accuracy of 1.2 ±1.4o for anteversion.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Kahn, A.M.A., Brakenbury, P.H., et al.: Dislocation following total hip replacement. J. Bone Joint Surg. 63B, 214–218 (1981)
McCollum, D.E., Gray, W.J.G.: Dislocation after Total Hip Arthroplasty. Causes and Prevention. Clin. Orthop. 261, 159–170 (1990)
Sarmiento, A., Ebramzadeh, E., et al.: Cup containment and orientation in cemented total hip arthoplasties. J. Bone Joint Surg. 72B, 960–996 (1990)
Bader, R.J., Steinhauser, E., Willmann, G., Gradinger, R.: The effects of implant position, design and wear on the range of motion after total hip arthroplasty. Hip International 11, 80–90 (2001)
Lewinnek, G.E., Lewis, J.L., et al.: Dislocation after total hip-replacement arthroplasties. J. Bone Joing Surg. 60A, 217–220 (1978)
Kotwal, R.S., Ganapathi, M., John, A., Maheson, M., Jones, S.A.: Outcome of treatment for dislocation after primary total hip replacement. J. Bone Joint Surg. 91B, 321–326 (2009)
Digioia III, A.M., Jaramaz, B., Plakseychuk, A.Y., et al.: Comparison of a mechanical acetabular alignment guide with computer placement of the socket. J. Arthroplasty 17, 359–364 (2002)
DiGioia III, A.M., et al.: The Otto Aufranc Award: image-guided navigation system to measure intraoperatively acetabular implant alignment. Clin. Orthop. 355, 8–22 (1998)
Bargar, W.L., et al.: Primary and revision total hip replacement using the Robodoc systems. Clin. Orthop. 354, 82–91 (1998)
Jaramaz, B., et al.: Computer assisted measurement of cup placement in total hip replacement. Clin. Orthop. 354, 70–81 (1998)
Taylor, R.H., et al.: Computer-integrated revision total hip replacement surgery: concept and preliminary results. Med. Image Anal. 3, 301–319 (1999)
Zheng, G., et al.: A hybrid CT-free navigation system for total hip arthroplasty. Comput. Aided Surg. 7, 129–145 (2002)
Dorr, L.D., et al.: Development of imageless computer navigation for acetabular component position in total hip replacement. Iowa Orthop. J. 25, 1–9 (2005)
Spencer, J.M., et al.: Computer navigation of the acetabular component: a cadaver reliability study. J. Bone Joint Surg. 88B, 972–975 (2006)
Asayama, I., et al.: Intraoperative pelvic motion in total hip Arthroplasty. J. Arthroplasty 19, 992–997 (2004)
Ezoe, M., et al.: Pelvic motion during total hip Arthroplasty with translateral and posterolateral approaches. J. Orthop. Sci. 10, 167–172 (2005)
Echeverri, S., et al.: Reliable acetabular cup orientation with a new gravity-assisted guidance system. J. Arthroplasty 21, 413–419 (2006)
Dong, X., et al.: Acetabular cup orientation using a statistical data based calibration table. In: Proc. of CAOS 2008, Hongkong, China, June 4-7, pp. 262–265 (2008)
Murray, D.W.: The definition and measurement of acetabular orientation. J. Bone Joint Surg. 75, 228–232 (1993)
Zheng, G.: Statistically deformable 2D/3D registration for estimating post-operative cup orientation from a single standard X-ray radiograph. Annals of Biomedical Engineering 38, 2910–2927 (2010)
Arai, N., et al.: Minimal radioation dose computered tomography for measurement of cup orientation in total hip arthroplasty. Journal of Arthroplasty 25, 263–267 (2010)
Beckmann, J., et al.: Cup positioning in THA: current status and pitfalls. A systematic evaluation of the literature. Arch. Orthop. Trauma Surg. 129, 863–872 (2009)
Kalteis, T., et al.: Position of the acetabular cup - accuracy of radiographic calculation compared to CT-based measurement. Eur. J. Radiol. 58, 294–300 (2006)
Lin, F., et al.: Validation of a computer navigation system and a CT method for determination of the orientation of implanted acetabular cup in total hip arthroplasty: a cadaver study. Clinical Biomechanics 23, 1004–1011 (2008)
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Zheng, G., Echeverri, S., Xie, W., Nolte, LP. (2011). PS-GANS: A Patient-Specific, Gravity Assisted Navigation System for Acetabular Cup Placement. In: Taylor, R.H., Yang, GZ. (eds) Information Processing in Computer-Assisted Interventions. IPCAI 2011. Lecture Notes in Computer Science, vol 6689. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-21504-9_10
Download citation
DOI: https://doi.org/10.1007/978-3-642-21504-9_10
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-21503-2
Online ISBN: 978-3-642-21504-9
eBook Packages: Computer ScienceComputer Science (R0)