Augmented Reality- vs Accelerometer-Based Portable Navigation System to Improve the Accuracy of Acetabular Cup Placement During Total Hip Arthroplasty in the Lateral Decubitus Position

Abstract

Background: There have been no studies regarding the effectiveness of augmented reality (AR)-based portable navigation systems compared with accelerometer-based portable navigation systems in total hip arthroplasty (THA).

Methods: We retrospectively compared THAs performed using an AR-based portable navigation system (n = 45) and those performed using an accelerometer-based portable navigation system (n = 42). All THAs were performed with the patient in the lateral decubitus position. The primary outcome was the absolute difference between cup placement angles displayed on the navigation screen and those measured on postoperative X-ray.

Results: The mean absolute differences were significantly smaller in the AR-based portable navigation system group than the accelerometer-based portable navigation system group in radiographic inclination (2.5° ± 1.7° vs 4.6° ± 3.1°; 95% confidence interval 1.1°-3.2°, P < .0001). Similarly, the mean absolute differences were significantly better in the AR-based portable navigation system group in radiographic anteversion (2.1° ± 1.8° vs 6.4° ± 4.2°; 95% confidence interval 3.0°-5.7°, P < .0001). Neither hip dislocation, surgical site infection, nor other complications associated with use of the navigation system occurred in either group.

Conclusion: The AR-based portable navigation system may provide more precise acetabular cup placement compared with the accelerometer-based portable navigation system in THA.

Keywords: augmented reality; computer-assisted surgery; hip; smartphone; virtual reality.