Artikel
Computer Navigation for Total Hip Arthroplasty is Associated with a Reduced Rate of Revision for Dislocation – A study of 6912 navigated THA procedures from the Australian Orthopaedic Association National Joint Replacement Registry
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Autoren
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Lukas Eckhard
- Zentrum für Orthopädie und Unfallchirurgie, Universitätsmedizin Mainz, Mainz, Germany
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Sujit Agarwal
- Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, United Kingdom
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Bill Walter
- Royal North Shore Hospital, Sydney, Australia
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Andrea Peng
- South Australian Health and Medical Research Institute, South Adelaide, Australia
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Alesha Hatton
- Australian Orthopaedic Association National, Joint Replacement Registry, Melbourne, Australia
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Bill Donnelly
- Australian Orthopaedic Association National, Joint Replacement Registry, Melbourne, Australia
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Philipp Drees
- Zentrum für Orthopädie und Unfallchirurgie, Universitätsmedizin Mainz, Mainz, Germany
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Richard de Steiger
- The University of Melbourne, Melbourne, Australia
| Veröffentlicht: | 26. Oktober 2021 |
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Gliederung
Text
Objectives: Use of computer navigation has been shown to produce more accurate cup position when compared with non-navigated total hip arthroplasty (THA) but so far there is only limited evidence to show its effect on clinical outcome. This study analysed data from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) to assess the impact of computer navigation on the rate of overall revision of primary total hip replacement and for revision for dislocation.
Methods: Data for all non-navigated and navigated primary THA performed for osteoarthritis in Australia from January 1, 2009 to December 31, 2019, was examined to assess the rate of revision. We analysed the effects of navigation on rate, reason and type of revision. Kaplan Meier estimates of survivorship were used to describe the time to first revision. Hazard ratios (HR) from Cox proportional hazard models, with adjustment for age, gender and head size, were used to compare revision rates between non-navigated and navigated THA. A frailty model was used for checking the effect of hospital and surgeon cluster effects.
Results and Conclusion: Computer navigation was used in 6912 primary THA for osteoarthritis. Its use has increased from 1.9% in 2009 to 4.4% of all primary THA performed in 2019. There was no difference in the rate of revision for all causes between navigated and non-navigated THA. The cumulative percent revision at 10 years for navigated THA was 4.0% (95% CI: 3.2, 4.9) compared to 4.6% (95% CI: 4.4, 4.7) for non-navigated THA. There was a lower rate of revision for dislocation in the navigation THA group. The cumulative percent revision at 10 years was 0.4% (95% CI: 0.2, 0.6) for navigated compared to 0.8% (95% CI: 0.8, 0.9) for non-navigated THA (HR adjusted for age, gender and head size =0.46 (95% CI: 0.29, 0.74); p=0.002).
This study demonstrates a reduced rate of revision for dislocation for THA associated with the use of computer navigation but no overall reduction in revision.
