Influence of obesity and intra-operative imaging guidance technology on acetabular cup positioning in total hip arthroplasty
Background Accuracy of acetabular cup positioning during total hip arthroplasty (THA) can be improved with intra-operative imaging but may be influenced by body mass index (BMI). This study assessed the influence of BMI (kg/m 2 ) on cup accuracy when using intra-operative fluoroscopy (IF) alone or s...
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| Veröffentlicht in: | Archives of orthopaedic and trauma surgery 2023-11, Vol.143 (11), p.6857-6863 |
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| creator | Luu, Kayti Nishioka, Scott T. Lawton, Dylan R. Y. Unebasami, Emily Andrews, Samantha N. Nakasone, Cass K. |
| description | Background
Accuracy of acetabular cup positioning during total hip arthroplasty (THA) can be improved with intra-operative imaging but may be influenced by body mass index (BMI). This study assessed the influence of BMI (kg/m
2
) on cup accuracy when using intra-operative fluoroscopy (IF) alone or supplemented with a commercial product.
Methods
This retrospective review included four consecutive cohorts of patients having undergone anterior approach THA with IF alone (2011–2015), IF and Overlay (2015–2016) (Radlink Inc., Los Angeles, CA), IF and Grid (2017–2018) (HipGrid Drone™, OrthoGrid Systems Inc., Salt Lake City, UT) and IF and Digital (2018–2020) (OrthoGrid Phantom®, OrthoGrid Systems, Inc., Salt Lake City, UT). Component placement accuracy was measured on 6-week post-operative weight bearing radiographs and compared between four BMI patient groups (BMI ≤ 25, 25 |
| doi_str_mv | 10.1007/s00402-023-04922-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2822367837</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2870182607</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-f7e3ea87c8a745e78775058c96968319dcf925e764b319bc8ec3ed0cd3a6a9113</originalsourceid><addsrcrecordid>eNp9kU1vFSEUhomxsbX6B1wYEjduxh5g7gBL0_jRpImbuiYMc2YuzVwYgTG9SX-83N5ajQtXfD3vC-Eh5A2DDwxAXmSAFngDXDTQas6bu2fkjLWibYRm3fO_5qfkZc63AIwrDS_IqZBcghT6jNxfhXFeMTikcaSxx-zLntowUB9Ksk1cMNnifyL1Ozv5MNFp9YM98AXdNsQ5TnsaA7UOi-3X2Sbq1oUusRb5GA4JH2iJxc506xdqU9mmuMw2l_0rcjLaOePrx_GcfP_86ebya3P97cvV5cfrxgm5Kc0oUaBV0ikr2w1KJeUGNsrpTndKMD24UfO637V9XfVOoRM4gBuE7axmTJyT98feJcUfK-Zidj47nGcbMK7ZcMW56KQSsqLv_kFv45pCfV2lJDDFOzhQ_Ei5FHNOOJol1f9Je8PAHNyYoxtT3ZgHN-auht4-Vq_9DoenyG8ZFRBHINejMGH6c_d_an8B3kGcUg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2870182607</pqid></control><display><type>article</type><title>Influence of obesity and intra-operative imaging guidance technology on acetabular cup positioning in total hip arthroplasty</title><source>SpringerLink Journals - AutoHoldings</source><creator>Luu, Kayti ; Nishioka, Scott T. ; Lawton, Dylan R. Y. ; Unebasami, Emily ; Andrews, Samantha N. ; Nakasone, Cass K.</creator><creatorcontrib>Luu, Kayti ; Nishioka, Scott T. ; Lawton, Dylan R. Y. ; Unebasami, Emily ; Andrews, Samantha N. ; Nakasone, Cass K.</creatorcontrib><description>Background
Accuracy of acetabular cup positioning during total hip arthroplasty (THA) can be improved with intra-operative imaging but may be influenced by body mass index (BMI). This study assessed the influence of BMI (kg/m
2
) on cup accuracy when using intra-operative fluoroscopy (IF) alone or supplemented with a commercial product.
Methods
This retrospective review included four consecutive cohorts of patients having undergone anterior approach THA with IF alone (2011–2015), IF and Overlay (2015–2016) (Radlink Inc., Los Angeles, CA), IF and Grid (2017–2018) (HipGrid Drone™, OrthoGrid Systems Inc., Salt Lake City, UT) and IF and Digital (2018–2020) (OrthoGrid Phantom®, OrthoGrid Systems, Inc., Salt Lake City, UT). Component placement accuracy was measured on 6-week post-operative weight bearing radiographs and compared between four BMI patient groups (BMI ≤ 25, 25 < BMI ≤ 30, 30 < BMI ≤ 35, and 35 < BMI). Total fluoroscopy times were also recorded directly from the fluoroscopy unit.
Results
Abduction angle significantly increased as BMI increased (
p
= 0.003) with IF alone but no difference was present in groups with guidance technology. Anteversion was significantly different between BMI groups for IF alone (
p
= 0.028) and Grid (
p
= 0.027) but was not different in Overlay (
p
= 0.107) or Digital (
p
= 0.210). Fluoroscopy time was significantly different between BMI categories for IF alone (
p
= 0.005) and Grid (
p
= 0.018) but was not different in Overlay (
p
= 0.444) or Digital (
p
= 0.170).
Conclusion
Morbid obesity (BMI > 35) increases risk for malpositioning of acetabular cups and increases surgical time with IF alone or the Grid. Additional IF guidance technology (Overlay or Digital) increased cup positioning accuracy without decreasing surgical efficiency.</description><identifier>ISSN: 1434-3916</identifier><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-023-04922-x</identifier><identifier>PMID: 37270739</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Accuracy ; Body mass index ; Hip Arthroplasty ; Joint replacement surgery ; Medicine ; Medicine & Public Health ; Orthopedics</subject><ispartof>Archives of orthopaedic and trauma surgery, 2023-11, Vol.143 (11), p.6857-6863</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-f7e3ea87c8a745e78775058c96968319dcf925e764b319bc8ec3ed0cd3a6a9113</citedby><cites>FETCH-LOGICAL-c375t-f7e3ea87c8a745e78775058c96968319dcf925e764b319bc8ec3ed0cd3a6a9113</cites><orcidid>0000-0003-0424-8401</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00402-023-04922-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00402-023-04922-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37270739$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Luu, Kayti</creatorcontrib><creatorcontrib>Nishioka, Scott T.</creatorcontrib><creatorcontrib>Lawton, Dylan R. Y.</creatorcontrib><creatorcontrib>Unebasami, Emily</creatorcontrib><creatorcontrib>Andrews, Samantha N.</creatorcontrib><creatorcontrib>Nakasone, Cass K.</creatorcontrib><title>Influence of obesity and intra-operative imaging guidance technology on acetabular cup positioning in total hip arthroplasty</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description>Background
Accuracy of acetabular cup positioning during total hip arthroplasty (THA) can be improved with intra-operative imaging but may be influenced by body mass index (BMI). This study assessed the influence of BMI (kg/m
2
) on cup accuracy when using intra-operative fluoroscopy (IF) alone or supplemented with a commercial product.
Methods
This retrospective review included four consecutive cohorts of patients having undergone anterior approach THA with IF alone (2011–2015), IF and Overlay (2015–2016) (Radlink Inc., Los Angeles, CA), IF and Grid (2017–2018) (HipGrid Drone™, OrthoGrid Systems Inc., Salt Lake City, UT) and IF and Digital (2018–2020) (OrthoGrid Phantom®, OrthoGrid Systems, Inc., Salt Lake City, UT). Component placement accuracy was measured on 6-week post-operative weight bearing radiographs and compared between four BMI patient groups (BMI ≤ 25, 25 < BMI ≤ 30, 30 < BMI ≤ 35, and 35 < BMI). Total fluoroscopy times were also recorded directly from the fluoroscopy unit.
Results
Abduction angle significantly increased as BMI increased (
p
= 0.003) with IF alone but no difference was present in groups with guidance technology. Anteversion was significantly different between BMI groups for IF alone (
p
= 0.028) and Grid (
p
= 0.027) but was not different in Overlay (
p
= 0.107) or Digital (
p
= 0.210). Fluoroscopy time was significantly different between BMI categories for IF alone (
p
= 0.005) and Grid (
p
= 0.018) but was not different in Overlay (
p
= 0.444) or Digital (
p
= 0.170).
Conclusion
Morbid obesity (BMI > 35) increases risk for malpositioning of acetabular cups and increases surgical time with IF alone or the Grid. Additional IF guidance technology (Overlay or Digital) increased cup positioning accuracy without decreasing surgical efficiency.</description><subject>Accuracy</subject><subject>Body mass index</subject><subject>Hip Arthroplasty</subject><subject>Joint replacement surgery</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedics</subject><issn>1434-3916</issn><issn>0936-8051</issn><issn>1434-3916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9kU1vFSEUhomxsbX6B1wYEjduxh5g7gBL0_jRpImbuiYMc2YuzVwYgTG9SX-83N5ajQtXfD3vC-Eh5A2DDwxAXmSAFngDXDTQas6bu2fkjLWibYRm3fO_5qfkZc63AIwrDS_IqZBcghT6jNxfhXFeMTikcaSxx-zLntowUB9Ksk1cMNnifyL1Ozv5MNFp9YM98AXdNsQ5TnsaA7UOi-3X2Sbq1oUusRb5GA4JH2iJxc506xdqU9mmuMw2l_0rcjLaOePrx_GcfP_86ebya3P97cvV5cfrxgm5Kc0oUaBV0ikr2w1KJeUGNsrpTndKMD24UfO637V9XfVOoRM4gBuE7axmTJyT98feJcUfK-Zidj47nGcbMK7ZcMW56KQSsqLv_kFv45pCfV2lJDDFOzhQ_Ei5FHNOOJol1f9Je8PAHNyYoxtT3ZgHN-auht4-Vq_9DoenyG8ZFRBHINejMGH6c_d_an8B3kGcUg</recordid><startdate>20231101</startdate><enddate>20231101</enddate><creator>Luu, Kayti</creator><creator>Nishioka, Scott T.</creator><creator>Lawton, Dylan R. Y.</creator><creator>Unebasami, Emily</creator><creator>Andrews, Samantha N.</creator><creator>Nakasone, Cass K.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0424-8401</orcidid></search><sort><creationdate>20231101</creationdate><title>Influence of obesity and intra-operative imaging guidance technology on acetabular cup positioning in total hip arthroplasty</title><author>Luu, Kayti ; Nishioka, Scott T. ; Lawton, Dylan R. Y. ; Unebasami, Emily ; Andrews, Samantha N. ; Nakasone, Cass K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-f7e3ea87c8a745e78775058c96968319dcf925e764b319bc8ec3ed0cd3a6a9113</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Accuracy</topic><topic>Body mass index</topic><topic>Hip Arthroplasty</topic><topic>Joint replacement surgery</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Luu, Kayti</creatorcontrib><creatorcontrib>Nishioka, Scott T.</creatorcontrib><creatorcontrib>Lawton, Dylan R. Y.</creatorcontrib><creatorcontrib>Unebasami, Emily</creatorcontrib><creatorcontrib>Andrews, Samantha N.</creatorcontrib><creatorcontrib>Nakasone, Cass K.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Health & Medical Complete (ProQuest Database)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of orthopaedic and trauma surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Luu, Kayti</au><au>Nishioka, Scott T.</au><au>Lawton, Dylan R. Y.</au><au>Unebasami, Emily</au><au>Andrews, Samantha N.</au><au>Nakasone, Cass K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Influence of obesity and intra-operative imaging guidance technology on acetabular cup positioning in total hip arthroplasty</atitle><jtitle>Archives of orthopaedic and trauma surgery</jtitle><stitle>Arch Orthop Trauma Surg</stitle><addtitle>Arch Orthop Trauma Surg</addtitle><date>2023-11-01</date><risdate>2023</risdate><volume>143</volume><issue>11</issue><spage>6857</spage><epage>6863</epage><pages>6857-6863</pages><issn>1434-3916</issn><issn>0936-8051</issn><eissn>1434-3916</eissn><abstract>Background
Accuracy of acetabular cup positioning during total hip arthroplasty (THA) can be improved with intra-operative imaging but may be influenced by body mass index (BMI). This study assessed the influence of BMI (kg/m
2
) on cup accuracy when using intra-operative fluoroscopy (IF) alone or supplemented with a commercial product.
Methods
This retrospective review included four consecutive cohorts of patients having undergone anterior approach THA with IF alone (2011–2015), IF and Overlay (2015–2016) (Radlink Inc., Los Angeles, CA), IF and Grid (2017–2018) (HipGrid Drone™, OrthoGrid Systems Inc., Salt Lake City, UT) and IF and Digital (2018–2020) (OrthoGrid Phantom®, OrthoGrid Systems, Inc., Salt Lake City, UT). Component placement accuracy was measured on 6-week post-operative weight bearing radiographs and compared between four BMI patient groups (BMI ≤ 25, 25 < BMI ≤ 30, 30 < BMI ≤ 35, and 35 < BMI). Total fluoroscopy times were also recorded directly from the fluoroscopy unit.
Results
Abduction angle significantly increased as BMI increased (
p
= 0.003) with IF alone but no difference was present in groups with guidance technology. Anteversion was significantly different between BMI groups for IF alone (
p
= 0.028) and Grid (
p
= 0.027) but was not different in Overlay (
p
= 0.107) or Digital (
p
= 0.210). Fluoroscopy time was significantly different between BMI categories for IF alone (
p
= 0.005) and Grid (
p
= 0.018) but was not different in Overlay (
p
= 0.444) or Digital (
p
= 0.170).
Conclusion
Morbid obesity (BMI > 35) increases risk for malpositioning of acetabular cups and increases surgical time with IF alone or the Grid. Additional IF guidance technology (Overlay or Digital) increased cup positioning accuracy without decreasing surgical efficiency.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>37270739</pmid><doi>10.1007/s00402-023-04922-x</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-0424-8401</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1434-3916 |
| ispartof | Archives of orthopaedic and trauma surgery, 2023-11, Vol.143 (11), p.6857-6863 |
| issn | 1434-3916 0936-8051 1434-3916 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2822367837 |
| source | SpringerLink Journals - AutoHoldings |
| subjects | Accuracy Body mass index Hip Arthroplasty Joint replacement surgery Medicine Medicine & Public Health Orthopedics |
| title | Influence of obesity and intra-operative imaging guidance technology on acetabular cup positioning in total hip arthroplasty |
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