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    Reduced variability of acetabular cup positioning with use of an imageless navigation system.
    Clin Orthop Relat Res 2004 Sep(426):159-63
    Department of Orthopaedic Surgery, Medical University of Innsbruck, Austria.
    Positioning the acetabular component is one of the most important steps in total hip arthroplasty; malpositioned components can result in dislocations, impingement, limited range of motion, and increased polyethylene wear. Conventional surgery makes use of specialized alignment guides provided by the manufacturers of the implants. The use of mechanical guides has been shown to result in large variations of cup inclination and version. We investigated acetabular cup alignment with the nonimage-based hip navigation system compared with a conventional mechanically guided procedure in 12 human cadavers. Postoperative cup position relative to the pelvic reference plane was assessed in both groups with the use of a three-dimensional digitizing arm. In the navigated group, a median inclination of 45.5 degrees and a median anteversion of 21.9 degrees (goals, 45 degrees and 20 degrees) were reached. In the control group, the median inclination was 41.8 degrees and the median anteversion was 24.6 degrees. The ninetieth percentile showed a much wider range for the control group (36.1 degrees-51.8 degrees inclination, 15 degrees-33.5 degrees anteversion) than for the navigated group (43.9 degrees-48.2 degrees inclination, 18.3 degrees-25.4 degrees anteversion). This cadaver study shows that computer-assisted cup positioning using a nonimage-based hip navigation system allowed for more consistent placement of the acetabular component.

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    Rev Chir Orthop Reparatrice Appar Mot 2007 May;93(3):238-46
    Service de Chirurgie Orthopédique, Hôpital Sainte-Marguerite, 270, boulevard Sainte-Marguerite, BP 29, 13274 Marseille Cedex 09.
    Purpose Of The Study: Actetabular component malpositioning during total hip arthroplasty (THA) increases the risk of dislocation, reduces the range of motion, and can be the cause of early wear and loosening. There have been numerous reports on the optimal orientation of the acebaular component in THA. Lewinnek et al recommended an abduction angle of 40+/-10 degrees and an anteversion of 15+/-10 degrees for cup alignment in THA. Read More
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    Clin Biomech (Bristol, Avon) 2008 Oct 9;23(8):1004-11. Epub 2008 Jun 9.
    Department of Physical Therapy and Human Movement Sciences, Northwestern University, 645 N. Michigan Avenue, Chicago, IL 60611, USA.
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    Comparison of conventional versus computer-navigated acetabular component insertion.
    J Arthroplasty 2007 Feb;22(2):151-9
    Facharzt für Orthopädie/Rheumatologie Sportmedizin, Chirotherapie, Phys. Med. Orthopädische Klinik, Brakel, Germany.
    This retrospective study compared the efficacy of computer navigation and conventional freehand techniques to place acetabular component orientation in the target position of acetabular cup inclination of 45 degrees and anteversion of 20 degrees . We selected 69 patients who had undergone total hip arthroplasty with freehand cup insertion who had computed tomography (CT) to plan for acetabular cup placement of the contralateral side. This group was compared with 98 patients who underwent CT-based cup insertion, and all had postoperative CT. Read More
    [Accuracy improvement of acetabular component placement using non-image based surgical navigation system].
    Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2007 Oct;21(10):1057-61
    Department of Orthopedics, Nanjing First Hospital Affiliated to Nanjing Medical Universty, Nanjing Jiangsu 210006, PR. China.
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