Imageless navigation for primary total hip arthroplasty: a meta-analysis study

Journal of Orthopaedics and Traumatology, vol. 23, pp. 21

Abstract

BACKGROUND: There has been a growing interest in imageless navigation for primary total hip arthroplasty (THA). Its superiority over standard THA is debated. This meta-analysis compared surgical duration, implant positioning, Harris Hip Score and rate of dislocation of imageless navigation versus conventional THA. METHODS: The present study was conducted according to the PRISMA 2020 guidelines. All the clinical trials comparing imageless navigation versus conventional for primary THA were accessed. In January 2022, the following databases were accessed: PubMed, Web of Science, Google Scholar and Embase. No time constraints were used for the search. The outcomes of interest were to compare cup inclination and anteversion, leg length discrepancy, surgical duration, Harris Hip Score and rate of dislocation of imageless navigation versus conventional THA. RESULTS: Twenty-one studies (2706 procedures) were retrieved. Fifty-two percent of patients were women. There was between-group comparability at baseline in terms of age, body mass index (BMI), visual analogue scale, Harris Hip Score and leg length discrepancy (P > 0.1). Compared with conventional THA, the navigated group demonstrated slightly lower leg length discrepancy (P = 0.02) but longer duration of the surgical procedure (P < 0.0001). Cup anteversion (P = 0.6) and inclination (P = 0.5), Harris Hip Score (P = 0.1) and rate of dislocation (P = 0.98) were similar between the two interventions. CONCLUSION: Imageless navigation may represent a viable option for THA.

Authors 6

1. Filippo Migliorini corresponding Aachen Department of Orthopaedic, Trauma, and Reconstructive Surgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, 52074, Aachen, Germany. migliorini.md@gmail.com

   Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, 52074, Aachen, Germany

2. Francesco Cuozzo

   University of Salerno

   Affiliation as printed

   Department of Medicine, Surgery and Dentistry, University of Salerno, 84081, Baronissi, SA, Italy

3. Francesco Oliva

   University of Salerno

   Affiliation as printed

   Department of Medicine, Surgery and Dentistry, University of Salerno, 84081, Baronissi, SA, Italy

4. Joerg Eschweiler Aachen Department of Orthopaedic, Trauma, and Reconstructive Surgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, 52074, Aachen, Germany

5. Frank Hildebrand Aachen Department of Orthopaedic, Trauma, and Reconstructive Surgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, 52074, Aachen, Germany

6. Nicola Maffulli

   University of London · University of Salerno · Queen Mary University of London · Mile End Hospital · Keele University

   Affiliation as printed

   Department of Medicine, Surgery and Dentistry, University of Salerno, 84081, Baronissi, SA, Italy

   Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, London, E1 4DG, UK

   School of Pharmacy and Bioengineering, Keele University Faculty of Medicine, Stoke on Trent, ST4 7QB, UK