Using Navigation in Direct Anterior Approach THA

    Is navigation compatible with the direct anterior approach to hip procedures? Does it improve cup positioning and leg length determination? Does it add surgical time?

    Stefan Kreuzer, MD, MS, Associate Professor at the University of Texas Health Science Center at Houston, Houston, Texas, sought to answer those questions in a recent retrospective review of 300 of his patients who underwent a direct anterior total hip arthroplasty.

    Dr. Kreuzer recently shared his results with attendees at the pre-course of the CAOS/Orlando 2013 meeting.

    Of the 300 patients, 150 underwent a conventional, non-navigated THA, while the other 150 patients had a navigated THA. Dr. Kreuzer compared three parameters:

    • Leg length discrepancy
    • Cup angle
    • Total surgical time (incision to final reduction)

    Navigation reduced discrepancies in leg length versus conventional THA, but the difference was not statistically significant. However, differences in cup angle and surgical time were highly statistically significant: The cup angle was more precise and surgical time was shorter when navigation was used versus conventional THA.

    Dr. Kreuzer said navigation can be easily incorporated into the anterior approach, and as his study results showed, it can benefit the patient in terms of shorter surgical time, more precision with the cup angle, and more accurate leg length.

    Although these preliminary results are promising, Dr. Kreuzer said more studies are needed.

    Dr. Kreuzer also showed a video of navigation with the anterior approach, and he offered his tips and tricks for placing the tracker and using navigation to check cup positioning and measure leg length.

    Watch this presentation by clicking the button below.