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Purpose: Accurate cup placement is challenging in total hip arthroplasty (THA) for dysplastic hip osteoarthritis (DHOA) because of the complex morphology of the acetabulum. Studies have reported good accuracy for total hip arthroplasty (THA) using computed tomography-based navigation (CTN); however, in recent years, portable navigation (PN) has become more widely applied because of its low cost and ease of use. This study aimed to compare the accuracy of portable navigation with that of CT-based navigation., Methods: A total of 114 patients underwent THA for DHOA via the standard posterior approach in the lateral decubitus position using the CTN (CTN-THA group) or PN (PN-THA group) system. After propensity score matching, 32 patients were included in each group. The accuracy of cup inclination, anteversion, cup placement position, and operative time were compared between the groups., Results: There was no difference in accuracy error between the CTN-THA (inclination 2.8 ± 2.0° and anteversion 3.4 ± 2.1°) and PN-THA groups (inclination 2.5 ± 1.8° and anteversion 2.6 ± 2.2°). The CTN-THA group (inclination 2.2 ± 2.0° and anteversion 2.1 ± 1.6°) achieved better navigation error compared to the PN-THA group (inclination 2.6 ± 2.2° and anteversion 3.8 ± 3.3°). The error of cup placement position in the anteroposterior direction was significantly larger in the PN-THA group (4.27 ± 3.02 mm) than in the CTN-THA group (2.13 ± 2.17 mm). The operative time was significantly longer in the CTN-THA group (115 ± 41 min) than in the PN-THA group (87 ± 19 min)., Conclusions: CTN-THA exhibited better accuracy than PN-THA for both cup placement angles and positions. CTN-THA tended to increase the operative time compared to PN-THA., Competing Interests: Declarations. Conflict of interests: The authors declare no competing interests. Consent to participate: Informed consent was obtained from all individual participants included in the study. Ethics approval: This study was approved by the Institutional Review Board of Nagoya University Hospital and performed in line with the principles of the Declaration of Helsinki (approval number: 2020–0272)., (© 2025. The Author(s).)

Background: Intraoperative femoral fractures are more common in cementless bipolar hip arthroplasty (BHA) for displaced femoral neck fractures than they are in cemented BHA and remain one of the major concerns. This study aimed to investigate the risk factors for intraoperative femoral fractures in cementless BHA., Methods: The study included 1,392 patients who underwent cementless BHA for displaced femoral neck fractures from January 2015 to December 2019 in 14 hospitals of the Trauma Research Group. They were divided into two groups according to the presence or absence of intraoperative femoral fractures, and factors associated with intraoperative fractures were statistically examined., Results: Forty (2.9 %) intraoperative and 28 (2.0 %) postoperative, totally 68 (4.9 %) femoral fractures occurred. The mean age of the patients, presence of opposite-side proximal femoral fracture, approach, and cementless stem design were significantly different between the two groups (P < 0.05). The logistic regression analysis model showed that a fully HA-coated stem (odds ratio, 4.12; 95 % confidence interval, 1.43-11.9) was an independent factor associated with intraoperative femoral fractures., Conclusion: This study investigated the risk factors associated with intraoperative fractures and showed that fully HA-coated stems were an independent factor associated with intraoperative femoral fractures. Surgeons should be cautious in the early stages of introducing fully HA-coated stems., Competing Interests: Declaration of competing interest No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article., (Copyright © 2024 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.)