The Study Of Clinical Efficacy Of OrthoPilot Navigation System In Total Hip Arthroplasty

Background Total hip arthroplasty(THA)is always used to treat osteonecrosis of the femoral head(ONFH),femoral neck fracture,Developmental Dysplasia of the Hip(DDH)and other diseases.Replacement of the corresponding lesions with a stable and durable artificial hip prosthesis can effectively relieve pain,restore the range of motion and reduce the recovery time,thus reducing the incidence of bedridden complications and having a high rate of postoperative satisfaction.It is regarded as one of the most successful surgical operations in the 20st century.However,the traditional THA depends on the surgeon’s judgment of the body surface markers and the empirical selection of the type of the prosthesis.Ortho Pilot navigation system is a semi-active non-image dependent navigation system for the acetabular side.During the operation,optical sensors are used to track the target bone and surgical tools or implants,so as to guide the selection of prosthesis implantation position and type.Ortho Pilot navigation system has been widely applied in artificial knee arthroplasty and has made remarkable achievements.However,the advantages and disadvantages of imageless navigation system represented by Ortho Pilot in THA have not been concluded at home and abroad.Objective To explore whether Ortho Pilot navigation-assisted THA can improve the accuracy and safety of acetabular cup prosthesis placement,and to evaluate the short-term clinical effect of patients after artificial prosthesis replacement.To evaluate the advantages and disadvantages of Ortho Pilot navigation technology compared with traditional surgery,and pave the way for further research.Methods A total of 23 patients who received Ortho Pilot navigation-assisted THA in the Department of Joint Surgery,the First Affiliated Hospital of Anhui Medical University from June 1,2019 to April 30,2022 were retrospectively collected.According to age,sex,body mass index(BMI)and preoperative Harris score(HHS),a total of 23 patients were matched with traditional unnavigated Freehand THA at the same time.In order to evaluate the accuracy of prosthesis implantation,the inclination angle and anteversion angle indicated by intraoperative navigation were compared with the standard anterior radiograph measurements of bilateral hip joints.In terms of the safety evaluation of prosthesis implantation,the proportion of acetabular cups in the"Lewinnek safe zone"was compared between the navigation group and the non-navigation group.In terms of clinical and postoperative efficacy,surgical time,postoperative drainage volume,average hemoglobin loss,total blood loss,postoperative HSS,Forgotten Joint Score(FJS)and Oxford Hip Score(OHS)were analyzed.Results After matching,there was no significant difference in age,gender,BMI and preoperative Harris score between the two groups,suggesting that the two groups of patients are comparable.In terms of the accuracy of acetabular implantation in the navigation group,there was no significant difference between inclination angle 41(40,45)°and postoperative inclination angle(42.6±5.5)°,and there was no significant difference between intraoperative anteversion angle 19(16,21)°and postoperative anteversion angle(19.3±3.9)°,suggesting that Ortho Pilot navigation assisted THA is accurate.In terms of the safety of acetabular cup implants,22 cases of acetabular implants were within the Lewinnek safe zone"and 1 case was outside the"Lewinnek safe zone"in the navigation group,while in the non-navigation group,17 cases were within the"Lewinnek safe zone"and 6 cases were outside the range,the difference was statistically significant(χ~2=4.212,p=0.04),suggesting that Ortho Pilot navigation-assisted THA is safe.In terms of operation time,the navigation group was(152.4±39.9)min and the non-navigation group was(115.3±35.4)min.There was significant difference between the two groups.There was no significant difference in total blood loss,postoperative drainage,average perioperative hemoglobin loss and postoperative HHS,FJS and OHS between the two groups.The average postoperative follow-up was 6 months,and there were no cases of dislocation,infection or early revision in the two groups.Conclusion Ortho Pilot navigation assisted THA can guide the positioning of acetabular prosthesis through optical sensors and other navigation devices,so as to obtain accurate anteversion and inclination angle of acetabular cup prosthesis and improve the safety of postoperative artificial hip joint.However,there was no significant difference between the short-term clinical efficacy and that of traditional non-navigational freehand THA.Medium-and long-term follow-up and complete randomized controlled trial(RCT)are helpful to clarify the difference in clinical efficacy between the two groups.