Development and validation of a navigational guidance system for acetabular implant placement

During the past year our group has been developing HipNav, a system which helps surgeons determine optimal, patient-specific acetabular implant placement and accurately achieve the desired implant placement during surgery. HipNav includes three components: a pre-operative planner, a range of motion simulator, and an intra-operative tracking and guidance system. The goals of the current HipNav system are to: 1) reduce dislocations following total hip replacement surgery due to acetabular malposition; 2) determine and potentially increase the “safe” range of motion; 3) reduce wear debris resulting from impingement of the implant’s femoral neck with the acetabular rim; and 4) track in real-time the position of the pelvis and acetabulum during surgery. The original implementation of the HipNav system was a proof-of-concept prototype which was useful for demonstrating the efficacy of this technology in-vitro. As the HipNav system progressed towards a clinical implementation, our efforts focussed on several practical development and validation issues. This paper describes our experience transforming HipNav from a proof-of-concept prototype into a robust clinical system, with emphasis on technical development and validation. Despite the highly applied nature of this endeavor, many fundamental research issues exist. The benefits of tightly coupling fundamental research together with applied development in our work are discussed.