Morbidity and Safety of Iliac Crest Reference Array Pins in Navigated Total Hip Arthroplasty: A Prospective Cohort Study

Navigated total hip arthroplasty (THA) can employ intra-osseous pins through a separate incision to secure reference arrays to the iliac crest. This study is the first to investigate the consequences of pin use in THA in vivo. A prospective, consecutive series of 43 patients presenting for navigated...

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Bibliographic Details
Published in:The Journal of arthroplasty 2018-05, Vol.33 (5), p.1557-1561
Main Authors: Lambers, Anton P., Salim, Xiang G., Jennings, Robert, Bucknill, Andrew T.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip - adverse effects
Bone Nails
Bone Screws
computer-assisted navigation
Female
Follow-Up Studies
Fractures, Bone - surgery
Humans
iliac crest
Ilium - surgery
Male
Middle Aged
Morbidity
pain
pin site
Prospective Studies
safety
Surgery, Computer-Assisted
total hip arthroplasty
total hip replacement
Young Adult
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Summary:Navigated total hip arthroplasty (THA) can employ intra-osseous pins through a separate incision to secure reference arrays to the iliac crest. This study is the first to investigate the consequences of pin use in THA in vivo. A prospective, consecutive series of 43 patients presenting for navigated THA were included. Two temporary 125 × 4 mm Schanz screws were inserted into the iliac crest for the attachment of a reference array. Telephone follow-up occurred at 6 and 12 weeks post-operatively. Patients were asked about pain, interference with daily activities, how often the wound was noticed, and duration of discomfort. Patient body mass index was recorded. The follow-up rate was 100%. Pin site pain at any time post-operatively was reported by 24 patients (56%). This improved to 30%, 9%, and 2% at 3, 6, and 12 weeks, respectively. On average, pain lasted for 16 days total. The most common complaints after pain were clothing discomfort (23%), pain when wearing a belt (12%), or pain when mobilizing (9%). For the majority (98%) of patients, all symptoms had resolved by 12 weeks. There was no nerve injury, pin site fracture, infection, or screw breakage. Patients with body mass index greater than 30 kg/m2 were up to 3 times more likely to experience pin site pain (P = .05), and had a longer duration of pain (P = .04). Surgeons and patients should be aware that using navigational pins for array fixation carries low complication rates but often will cause pain and irritation that resolves in the short term.
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2017.12.032