Computer-Navigated Total Hip Replacement

What is Computer-Navigated Total Hip Replacement?

For a successful total hip replacement, accurate positioning of the implants is crucial to accomplish a good clinical outcome. Computer-navigated total hip replacement is an advanced technology developed to provide more accurate positioning of an implant. Hip replacement through computer navigation provides information and guidance to the surgeon for precise positioning of implants.

Anatomy of the Hip

The hip joint is one of the body’s largest weight-bearing joints and is the point where the thighbone (femur) and pelvis (acetabulum) join. It is a ball-and-socket joint in which the head of the femur forms the ball and the pelvic acetabulum forms the socket. The joint surface is covered by smooth articular cartilage that cushions and enables smooth movement of the joint. The bones are held together by bands of tissue called ligaments that provide stability to the joint.

Indications for Computer-Navigated Total Hip Replacement

Indications for a computer-navigated total hip replacement include:

• Failed total hip replacement
• Malpositioning of the acetabular component
• Dislocation of the joint
• Impingement of the prosthesis
• Aseptic loosening of the prosthesis
• Periprosthetic osteolysis
• Polyethylene liner wear of the implant
• Prosthetic joint infection

Preoperative Assessment

A preoperative assessment will be made before surgery to check your overall health to make sure you are ready for the surgery. You will be advised as to the pros and cons of the procedure in detail before obtaining your consent. A dental evaluation will be made to check for any dental conditions. You will be asked about any medications or supplements you are taking, and the need to stop if necessary. You will have an anesthetic assessment to decide on what type of anesthesia will be used during surgery. You will be given antibiotics to reduce the risk of wound infection following surgery. An anticoagulant (blood thinner) such as heparin may be given since the surgery carries the risk of blood clots. Make sure to inform your doctor about any allergy to medications or latex. If you are a smoker, inform your doctor, as nicotine prevents bone fusion. Your doctor will also discuss the need to avoid food and drink after midnight the night prior to your surgery.

Procedure for Computer-Navigated Total Hip Replacement

The procedure is done under general anesthesia with you appropriately placed on the operating table. Computer navigation provides real-time imaging of the affected joint and surgical instruments during surgery. Data for the images are provided by infrared sensors fixed to the bones of the joint and the surgical instruments. Their position is tracked by an infrared camera situated above the surgical table linked to the computer and guides the surgeon’s progress. Once the surgery is completed, the incision is closed with a sterile dressing and sutures.

Postoperative Care and Instructions

Within 24 hours post-surgery, most patients are able to sit and stand and are encouraged to walk with assistance. A physical therapist or nurse will give appropriate instructions on the management of the hip as it heals. Patients may be asked to use compression stockings and blood thinners to prevent the possibility of blood clots in the legs. Most patients take about 6 weeks to 3 months to walk normally and to engage in their normal activities.

Other instructions to follow post-surgery include:

• Limiting any weight-bearing activities
• Keeping your leg elevated to decrease swelling
• Using assistive devices such as a walker, cane, or crutches
• Taking care of the sutures and dressing, as directed
• Participating in physical therapy and an exercise regimen to strengthen muscles
• Adhering to medications 
• Adhering to follow-up appointments

What are the Advantages of Computer-Navigated Total Hip Replacement?

Some of the advantages of computer-navigated hip replacement include:

• Short stay in the hospital
• Minimal scarring
• Less blood loss
• Small incisions
• Longevity of implant
• Precise positioning of implants
• Improved alignment
• Minimal tissue loss
• Minimal chance of implant displacement

What are the Risks and Complications of Computer-Navigated Total Hip Replacement?

Some of the complications and risks involved with computer-navigated total hip replacement include:

• Infection
• Thromboembolism or blood clots
• Injury to nerves and vessels
• Femoral fracture
• Component malposition
• Limited visibility of vital structures and anatomical landmarks