Summary

The computer assisted visualization software does not significantly lengthen femoroplasty or fluoroscopy time during cam resection.

Abstract

Purpose

To evaluate intraoperative femoroplasty time and radiation exposure in patients undergoing cam resection with use of image-based computer assisted visualization (CAV) software and conventional fluoroscopy versus conventional intraoperative fluoroscopy alone.

Methods

Patients undergoing hip arthroscopy for the clinical and radiographic diagnosis of cam dependent femoroacetabular impingement in a high-volume quaternary referral hip preservation practice with two experienced hip preservation surgeons (one senior, one junior) were prospectively enrolled in the study. Randomization into the conventional fluoroscopy or CAV arms was performed at the time of surgery. Surgical data including femoroplasty time and radiation exposure, as well as radiographic indices and postoperative outcome scores were compared between the two groups.

Results

There were 18 (10 female) patients in the conventional fluoroscopy (control) group and 19 (14 female) patients in the computer assisted visualization software group. There were no significant differences when comparing the control group and CAV group based on femoroplasty time (17.8±10.2 vs. 23.4±15.8 minutes; p=0.26) or fluoroscopic exposure time (39.8±36.4 vs. 56.8±79.8 seconds; p=0.45). The senior surgeon had significantly lower femoroplasty time (14.1±7.3 vs. 31.0±7.6 minutes; p=0.002) and radiation exposure in the conventional fluoroscopy group compared to the junior surgeon (4.9±3.6 vs. 12.9±6.4 mGy; p=0.03). However, there were no significant differences in femoroplasty time (20.1±16.2 vs. 29.4 ±10.1 p=0.27) or radiation exposure between the two surgeons in the computer assisted visualization cohort (5.7±2.7 vs. 8.9±5.2; p=0.13).

Conclusion

The computer assisted visualization software does not significantly lengthen femoroplasty or fluoroscopy time during cam resection. Additionally, computer assisted visualization software may decrease femoroplasty time and radiation exposure during the learning curve in hip arthroscopy, supporting this technology as promising tool in supporting accurate and reliable cam resection during hip arthroscopy.