Introduction: Systems available for computer-assisted hip resurfacing mostly differ from each other in the image modalities. Results using fluoroscopic [1] and CT-based systems [2] have been reported. The VectorVision(R) hip SR product (BrainLAB, Heimstetten, Germany) uses an image-less approach, where planning and navigation is based on intraoperatively digitized bony points. In the imageless approach, the entire surface of the neck is supposed to be digitized, but the exposure is determined by the approach used by the surgeon. The different surgical exposures have their own advantages and disadvantages [3,4] and different parts of the world tend to use different exposures for hip surgery. The purpose of our study was to test how different surgical approaches affect the accuracy of imageless navigated resurfacing surgery. Our hypothesis was that difficulty in digitizing certain aspects of the femoral neck would cause differences in planning and navigation.
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