Surgical Navigation

Computer-assisted surgical navigation of the hip is a relatively new field. Dr. Murphy has been a leader in this field since its inception. His contributions to surgical navigation of the hip include having performed the first peri-acetabular osteotomy with navigation of repositioning of the acetabular component in 1995, the first total hip replacement with navigation of the femoral component in 1997, the first hip replacement with fluoroscopic navigation in 2001, the first computer-assisted arthroscopic osteochondroplasty for femoroacetabular impingement in 2001, and the first computer-assisted acetabular osteochondroplasty using 2D-3D matching in 2006. He has routinely replaced hips using surgical navigation since 2001.

Regarding total hip arthroplasty, one of the most critical technical challenges involves accurate placement of the acetabular component. Using surgical navigation methods to track the position of the pelvis and the relative position of the acetabular component as it is being implanted is the most reliable method of performing this step of the procedure. Proper acetabular cup positioning can be challenging because the patient's pelvis moves around during hip replacement surgery and it's impossible to know the exact position of the pelvis at the moment that the acetabular cup is being inserted unless the motion of the pelvis is tracked during surgery. Even taking xrays during surgery has limitations because the exact angle of the xray is not known so precise measurements are difficult to make.

Acetabular component malposition can lead to an increased likelihood of a number of problems including accelerated wear of the hip, bone loss around the hip due to the wear debris, impingement of the components, or dislocation of the hip and can lead to repeat surgery for any of these problems. Using computer assistance to measure the position and orientation of the acetabular cup during its insertion is a very important application of surgical navigation since improved component positioning inevitably leads to a lower incidence of all of these problems.

Computer-assisted surgical navigation of acetabular component implantation involves calculating and tracking the position of the pelvis during surgery and then calculating the position of the prosthetic acetabular component relative to the pelvis as it is being implanted.

Dr. Murphy has performed more than 800 hip arthroplasties using surgical navigation to date which is the largest series of image-guided hip arthroplasties in North America and probably anywhere. He is also the immediate past president and executive board member of the International Society for Computer Assisted Orthopedic Surgery.

Most of these computer-assisted total hip replacements are also performed using tissue-preserving, minimally invasive techniques. The combination of less-invasive surgical techniques and image-guided surgical navigation holds much greater promise than either of the new techniques alone. When considering all of these issues though, each patient should remember that the true goal of hip replacement surgery is to have a well functioning hip for 10, 20, or 30 years. Whether a patient can walk well without crutches at 3 or 6 or 9 or 12 weeks isn't really the most important issue. All of our newer techniques must always be thought of with the long-term goals in mind. For more information about computer-assisted surgical navigation, click on the references below.


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Murphy SB, Ecker TM, Tannast M. Two to 9 year clinical results of alumina ceramic-ceramic total hip arthroplasty. Clinical Orthopedics and Related Research. 453, pp.97-102. 2006.

Murphy SB. Minimally Invasive, Computer-Assisted vs Conventional Total Hip Arthroplasty: A Prospective Assessment of Safety and Recovery. Computer Assisted Orthopedic Surgery International, Chicago, June, 2004.

Experience with Fluoroscopic and CT-Based Navigation for Total Hip Arthroplasty, European Hip Society, Innsbruck, June, 2004.

Clinical Results of Comptuer-Assisted Total Hip Replacement, International Conference on Computer-Assisted Orthopedic Surgery, Marbella, Spain, 2003.

Image-Guided Surgical Navigation : Basic Principles and Applications to Reconstructive Surgery, Orthopedic Journal at Harvard Medical School, 2002.