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Purpose <p>Accurate acetabular cup placement is essential in total hip arthroplasty (THA). We hypothesized that the newly introduced Computed Tomography (CT)-based portable navigation system would demonstrate accuracy comparable to that of the imageless portable navigation system. The aim of this study was to compare cup placement accuracy between the CT-based and imageless portable navigation systems of the same platform in THA performed in the lateral decubitus position.</p> Methods <p>This retrospective cross-sectional study included 36 patients who underwent primary THA via a direct lateral approach in the lateral decubitus position. In all cases, both imageless and CT-based portable navigation systems were used concurrently. Postoperative cup alignment was evaluated using three-dimensional CT (3D-CT). The primary outcome was the absolute error in cup inclination and anteversion, defined as the difference between intraoperative navigation values and postoperative 3D-CT measurements in the functional. Secondary outcomes included outlier rates and registration success rates.</p> Results <p>No statistically significant differences were observed between the imageless and CT-based portable navigation systems in the mean absolute error for inclination (2.2 ± 1.8° vs. 2.3 ± 1.8°, <i>p</i> = 0.93) or anteversion (2.3 ± 2.3° vs. 2.6 ± 2.5°, <i>p</i> = 0.41). There were no significant differences in outlier proportions. The registration success rate was 92% (36/39) due to three&#xa0;technical failures.</p> Conclusion <p>In this preliminary study, the CT-based portable navigation system demonstrated cup placement accuracy comparable to that of the imageless portable navigation system. Although the CT-based system may provide additional spatial information intraoperatively, its impact on clinical outcomes remains unclear and requires further longitudinal investigation.</p>

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A preliminary validation study showing comparable accuracy between Computed Tomography based and imageless portable navigation systems when both systems are used

  • 期刊论文

  • 发表日期：

    2026年6月22日

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  • Yuichi Miura,
  • Hideki Ueyama,
  • Ryo Sugama,
  • Yukihide Minoda,
  • Yohei Ohyama,
  • Sho Masuda,
  • Ryosuke Kirihigashi,
  • Hidetomi Terai

摘要

Purpose

Accurate acetabular cup placement is essential in total hip arthroplasty (THA). We hypothesized that the newly introduced Computed Tomography (CT)-based portable navigation system would demonstrate accuracy comparable to that of the imageless portable navigation system. The aim of this study was to compare cup placement accuracy between the CT-based and imageless portable navigation systems of the same platform in THA performed in the lateral decubitus position.

Methods

This retrospective cross-sectional study included 36 patients who underwent primary THA via a direct lateral approach in the lateral decubitus position. In all cases, both imageless and CT-based portable navigation systems were used concurrently. Postoperative cup alignment was evaluated using three-dimensional CT (3D-CT). The primary outcome was the absolute error in cup inclination and anteversion, defined as the difference between intraoperative navigation values and postoperative 3D-CT measurements in the functional. Secondary outcomes included outlier rates and registration success rates.

Results

No statistically significant differences were observed between the imageless and CT-based portable navigation systems in the mean absolute error for inclination (2.2 ± 1.8° vs. 2.3 ± 1.8°, p = 0.93) or anteversion (2.3 ± 2.3° vs. 2.6 ± 2.5°, p = 0.41). There were no significant differences in outlier proportions. The registration success rate was 92% (36/39) due to three technical failures.

Conclusion

In this preliminary study, the CT-based portable navigation system demonstrated cup placement accuracy comparable to that of the imageless portable navigation system. Although the CT-based system may provide additional spatial information intraoperatively, its impact on clinical outcomes remains unclear and requires further longitudinal investigation.