Navigation of the total hip replacement - Concept, development, and first experiences of CT-based and image-free shaft and cup navigation systems

摘要

Computer assisted navigation of the acetabular cup implant in total hip endoprosthetics is already performed on a routine basis in many hospitals. However, cup implantation is not even half of a total hip replacement (THR). So far, neither implantation of the shaft, nor optimization of the implant positioning with respect of the functional harmony is supported. Current surgical strategies leave these topics to the qualitative estimation of the surgeon. Especially leg length, but also offset are essential geometric factors worth of quantitative consideration. Therefore, this is the subsequent next step in further developments in THR navigation. The technologies of CT-based, as well as image-free navigation are established for other implants and procedures. Using these, the development of shaft navigation is realized. During conception and our first experience in the operation theater on one hand useful criteria and necessary changes in the navigation procedure could be defined, on the other hand problems and limitations of each system were apparent.