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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 3, 310-315.
doi: 10.1302/0301-620X.91B3.21288  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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Imageless computer navigation for placement of the femoral component in resurfacing arthroplasty of the hip

M. Olsen, BSc, PhD, Doctoral Researcher1; E. T. Davis, MSc, FRCS(Trauma & Orth), Consultant Orthopaedic and Trauma Surgeon2; J. P. Waddell, MD, FRCS C, Professor of Surgery1; and E. H. Schemitsch, MD, FRCS C, Professor of Surgery, Head Division of Orthopaedic Surgery3

1 Division of Orthopaedic Surgery, Department of Surgery, St Michael’s Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, Canada M5B 1W8.
2 Royal Orthopaedic Foundation NHS Trust, Bristol Road South, Northfield, Birmingham B31 2AP, UK.
3 Department of Surgery St Michael’s Hospital, University of Toronto, 800-55 Queen Street East, Toronto, Ontario, Canada M5C 1R6.

Correspondence should be sent to Dr E. H. Schemitsch; e-mail: schemitsche{at}smh.toronto.on.ca

We have investigated the accuracy of placement of the femoral component using imageless navigation in 100 consecutive Birmingham Hip Resurfacings. Pre-operative templating determined the native neck-shaft angle and planned stem-shaft angle of the implant. The latter were verified post-operatively using digital anteroposterior unilateral radiographs of the hip.

The mean neck-shaft angle determined before operation was 132.7° (118° to 160°). The mean planned stem-shaft angle was a relative valgus alignment of 9.7° (SD 2.6). The stem-shaft angle after operation differed from that planned by a mean of 2.8° (SD 2.0) and in 86% of cases the final angle measured within ± 5° of that planned. We had no instances of notching of the neck or varus alignment of the implant in our series. A learning curve was observed in the time taken for navigation, but not for accurate placement of the implant.

Navigation in hip resurfacing may afford the surgeon a reliable and accurate method of placement of the femoral component.




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M. Olsen, E. T. Davis, M. Chiu, P. Gamble, N. Tumia, R. A. Boyle, and E. H. Schemitsch
Imageless computer navigation without pre-operative templating may lead to malpreparation of the femoral head in hip resurfacing
J Bone Joint Surg Br, October 1, 2009; 91-B(10): 1281 - 1286.
[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General