Accuracy and Reliability of Combining a Smartphone and a Digital Angle Ruler Technique to Assist Acetabular Cup Placement: A Pelvic Model Study

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Published: Oct 1, 2019
Keywords:
Accuracy Reliability Smartphone Digital angle ruler Acetabular cup placement

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Charoenwat Uthaicharatratsame, MD
Department of Orthopedic Surgery, Nopparat Rajathanee Hospital, Bangkok, Thailand
Somboon Sahajarupat, MD
Department of Orthopedic Surgery, Nopparat Rajathanee Hospital, Bangkok, Thailand
Teerapat Adullayathum, MD
Department of Orthopedic Surgery, Nopparat Rajathanee Hospital, Bangkok, Thailand

Abstract

Objective: To examine the accuracy and reliability of a method that used a smartphone and a digital angle ruler for improving the acetabular cup placement in a pelvic model. 


Materials and Methods: An experimental study was conducted in a plastic pelvic model. During the cup placement at the target of radiographic inclination (RI) 40º and anteversion (RA) 15º verified by the Orthopilot navigation system, 3 orthopedic surgeons simultaneously assessed the cup orientation by a smartphone application for the anteversion and a digital angle ruler for the inclination. The surgeon-measured angles were calculated into the RI and RA values by Murray’s equation; and then used to compare with the target angle by the navigation system.


Results: The mean RI and RA angles from the 3 surgeons were 40.08º ± 2.15º and 11.01º ± 0.35º, respectively. The mean differences between the RI and RA angles from the navigation system and those calculated from the combined devices were 0.80º ± 2.15º (-3.10º to 5.3º) and -3.98º ± 0.35º (-4.60º to -3.30º), respectively. Both intra-tester and inter-tester reliabilities were good to excellent in the assessment of the cup RI and RA.


Conclusion: Use of smartphone application combined with a digital angle ruler could provide a high accuracy of acetabular cup positioning, especially for the inclination angle.

Article Details

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Vol. 43 No. 3-4 (2019): July-October
Section
Articles

References

1. Biedermann R, Tonin A, Krismer M, Rachbauer F, Eibl G, Stockl B. Reducing the risk of dislocation after total hip arthroplasty: the effect of orientation of the acetabular component. J Bone Joint Surg Br. 2005; 87(6): 762-9.
2. Hirakawa K, Mitugi N, Koshino T, Saito T, Hirasawa Y, Kubo T. Effect of acetabular cup position and orientation in cemented total hip arthroplasty. Clin Orthop Relat Res. 2001; 388: 135-42.
3. Little NJ, Busch CA, Gallagher JA, Rorabeck CH, Bourne RB. Acetabular polyethylene wear and acetabular inclination and femoral offet. Clin Orthop Relat Res. 2009; 467(11): 2895-900.
4. Beckmann J, Stengel D, Tingart M, Gotz J, Grifka J, Luring C. Navigated cup implantation in hip arthroplasty: a meta-analysis. Acta Orthop. 2009; 80(5): 538-44.
5. Iwana D, Nakamura N, Miki H, Kitada M, Hananouchi T, Sugano N. Accuracy of angle and position of the cup using computed tomography-based navigation systems in total hip arthroplasty. Comput Aided Surg. 2013; 18(5-6): 187-94.
6. Kim TH, Lee SH, Yang JH, Oh KJ. Computed topography assessment of image-free navigation-assisted cup placement in THA in an Asian population. Orthopedics. 2012; 35(10) (suppl): 13-7.
7. Ryan JA, Jamali AA, Bargar WL. Accuracy of computer navigation for acetabular component placement in THA. Clin Orthop Relat Res. 2010; 468(1):169-77.
8. Xu K, Li YM, Zhang HF, Wang CG, Xu YQ, Li ZJ. Computer navigation in total hip arthroplasty: a meta-analysis of randomized controlled trials. Int J Surg. 2014; 12(5); 528-33.
9. Peter FM, Greeff R, Goldstein N, Frey CT. Improving acetabualr cup orientation in total hip arthroplasty by using smartphone technology. J Arthroplasty. 2012; 27(7): 1324-30.
10. Kurosaka K, Fukunishi S, Fukui T, Nishio S, Fujihara Y, Okahisa S, et al. Assessment of accuracy and reliability in acetabular cup placement using an iPhone/iPad system. Orthopedics. 2016; 39(4): 621-26.
11. Kulendran M, Lim M, Laws G, Chow A, Nehme J, Darzi A, et al. Surgical smartphone applications across different platforms: their evolution, uses and users. Surgical Innovation. 2014; 21(4): 427-40.
12. Franko OI. Smartphone apps for orthopaedic surgeons. Clin Orthop Relat Res. 2011; 469(7): 2042-8.

13. Murray DW. The definition and measurement of acetabular orientation. J Bone Joint Surg Br. 1993; 75(2): 228-32.
14. Fukunishi S, Fukui T, Imamura F, Nishio S. Assessment of accuracy of acetabular cup orientation in CT- free navigated total hip arthroplasty. Orthopedics. 2008; 31(10): 987- 90.
15. Dorr LD, Hishiki Y, Wan Z, Newton D, Yun A. Development of imageless computer navigation of acetabular component position in total hip replacement. Iowa Orthop J. 2005; 25: 1-9.
16. Parratte S, Argenson JN. Validation and usefulness of a computer-assisted cup positioning system in total hip arthroplasty. A prospective, randomized, controlled study. J Bone Joint Surg Am. 2007; 89(3): 494-9.
17. Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR. Dislocation after total hip replacement arthroplasties. J Bone Joint Surg. 1978; 60(2): 217-20.
18. Sukapan H. Smartphone improves accuracy of alignment guide for acetabular cup positioning: a study in plastic bone model. Lampang Med J. 2014; 35(2):56-67.