scholarly journals Robotic-arm assisted total hip arthroplasty

2018 ◽  
Vol 6 (22) ◽  
pp. 433-433 ◽  
Author(s):  
Matthew S. Hepinstall ◽  
Nipun Sodhi ◽  
Joseph O. Ehiorobo ◽  
Shazaan Hushmendy ◽  
Michael A. Mont
Author(s):  
Matthew Hepinstall ◽  
Harrison Zucker ◽  
Chelsea Matzko ◽  
Morteza Meftah ◽  
Michael Mont

Introduction: Longevity and success of total hip arthroplasty (THA) is largely dependent on component positioning. While use of robotic platforms can improve this positioning, published evidence on its clinical benefits is limited. Therefore, the aim of this study was to assess the clinical outcomes of THA with robotic surgical assistance. Materials and Methods: We conducted an analysis of robotic arm-assisted primary THAs performed by a single surgeon utilizing a posterior approach. A total of 99 patients (107 cases) who had a minimum two-year follow up were identified. Their mean age was 61 years (range, 33 to 84 years), and their mean body mass index was 30.5 kg/m2 (range, 18.5 to 49.1 kg/m2). There were 56% female patients and primary osteoarthritis was the principal hip diagnosis in 88.8%. Operative times, lengths of hospital stay, and discharge dispositions were recorded, along with any complications. Modified Harris Hip Scores (HHS) were calculated to quantify clinical outcomes. Results: Mean postoperative increases in HHS at 2- to 5.7-year follow up was 33 points (range, 6 to 77 points). There were no complications attributable to the use of robotic assistance. Surgical-site complications were rare; one case underwent a revision for prosthetic joint infection (0.93%) but there were no dislocations, periprosthetic fractures, or cases of mechanical implant loosening. There was no evidence of progressive radiolucencies or radiographic failure. Discussion: Robotic arm-assisted THA resulted in low complication rates at minimum two-year follow up, with clinical outcomes comparable to those reported with manual surgery.1–4 The haptically-guided acetabular bone preparation enabled reliable cementless acetabular fixation and there were no adverse events related to the use of the robot. Dislocations were avoided in this case series. Randomized controlled clinical trials are needed to compare manual to robotic surgery and to investigate whether the precision found with this functional planning will reliably reduce the incidence of dislocations.


2020 ◽  
Vol 12 (2) ◽  
pp. 686-691
Author(s):  
Wei Chai ◽  
Ren‐wen Guo ◽  
Ken Lee Puah ◽  
Seth Jerabek ◽  
Ji‐ying Chen ◽  
...  

2020 ◽  
Author(s):  
Nao Shibanuma ◽  
Kazunari Ishida ◽  
Tomoyuki Matsumoto ◽  
Koji Takayama ◽  
Yutaro Sanada ◽  
...  

Abstract Background The purpose of this study was to compare the clinical outcomes of total hip arthroplasty (THA) using computer navigation systems (nTHA) and those of robotic arm-assisted THA (rTHA).Methods Thirty prospective subjects who underwent rTHA were clinically compared with 30 subjects who underwent nTHA. Clinical data (the surgical time, intraoperative blood loss, length of hospital stay, pain severity, number of days to independent walking, and Harris Hip Score (HHS) at discharge) and radiographic parameters (the inclination and anteversion angles) were statistically compared between the two groups. Results The surgical time, number of days to independent walking, and postoperative pain were significantly reduced in the rTHA group than in the nTHA group. The rTHA group showed a significantly higher postoperative HHS than did the nTHA group. No statistically significant difference was observed in radiographic parameters between the groups.Conclusion The surgical time, postoperative pain, and number of days to independent walking were significantly shorter, and the HHS at discharge was significantly higher in the rTHA group than in the nTHA group. Thus, as compared to nTHA, rTHA improved early clinical outcomes.


Orthopedics ◽  
2020 ◽  
Author(s):  
Itay Perets ◽  
John P. Walsh ◽  
Brian H. Mu ◽  
Yosif Mansor ◽  
Philip J. Rosinsky ◽  
...  

Author(s):  
Sheng Xu ◽  
Lawrence Bernardo ◽  
Khye Yew ◽  
Hee Pang

Introduction: The aim of this study was to investigate the accuracy of implant position of robotic-arm assisted total hip arthroplasty (THA) via the direct anterior approach (DAA). Materials and Methods: All patients who underwent robotic-arm assisted DAA THA (MAKO Surgical Corp., Ft. Lauderdale, Florida) from November 2018 to January 2020 were prospectively followed up. Pelvis indices (limb length discrepancy, femoral and hip offset, implant inclination, and anteversion), surgical duration, length of stay, and complications were recorded. To further evaluate the accuracy of robotic-arm assisted THA, patients who underwent manual DAA THA by the same surgeon were match-paired with the study group. Results: Twenty-five patients underwent robotic-arm assisted DAA THR. Limb length discrepancy was restored to 0.1mm (±3.4mm) from 10.0mm (±6.4mm) postoperatively. Preoperatively, the difference in femoral offset was 5.1mm (±5.1mm), and this was corrected to 1.9mm (±6.5mm) postoperatively. Nine cases had target inclination of 40° and mean inclination achieved was 40.7° (±0.9°). Sixteen cases had target inclination of 45° and mean inclination achieved was 45.3° (±1.0°). Mean anteversion was 19.5° (±2.4°). Propensity matched analysis showed that the root mean square errors for manual cup implantation compared to the robotic-arm assisted group was 2.3 times higher for anteversion and 6.3 times higher for inclination. Fourteen (56%) of the cups were within Callanan safe-zone and 18 (72%) within Lewinnek safe-zone in the manual group compared to 18 (72%) and 25 (100%), respectively, in the robotic-arm assisted group. Conclusion: Combining the muscle-sparing technique of DAA with the improved implant placement with the robotic-arm assisted platform is a promising solution to improving THA outcomes.


2021 ◽  
Vol 2 (6) ◽  
pp. 365-370
Author(s):  
Nicholas Kolodychuk ◽  
Edwin Su ◽  
Michael M. Alexiades ◽  
Renee Ren ◽  
Connor Ojard ◽  
...  

Aims Traditionally, acetabular component insertion during total hip arthroplasty (THA) is visually assisted in the posterior approach and fluoroscopically assisted in the anterior approach. The present study examined the accuracy of a new surgeon during anterior (NSA) and posterior (NSP) THA using robotic arm-assisted technology compared to two experienced surgeons using traditional methods. Methods Prospectively collected data was reviewed for 120 patients at two institutions. Data were collected on the first 30 anterior approach and the first 30 posterior approach surgeries performed by a newly graduated arthroplasty surgeon (all using robotic arm-assisted technology) and was compared to standard THA by an experienced anterior (SSA) and posterior surgeon (SSP). Acetabular component inclination, version, and leg length were calculated postoperatively and differences calculated based on postoperative film measurement. Results Demographic data were similar between groups with the exception of BMI being lower in the NSA group (27.98 vs 25.2; p = 0.005). Operating time and total time in operating room (TTOR) was lower in the SSA (p < 0.001) and TTOR was higher in the NSP group (p = 0.014). Planned versus postoperative leg length discrepancy were similar among both anterior and posterior surgeries (p > 0.104). Planned versus postoperative abduction and anteversion were similar among the NSA and SSA (p > 0.425), whereas planned versus postoperative abduction and anteversion were lower in the NSP (p < 0.001). Outliers > 10 mm from planned leg length were present in one case of the SSP and NSP, with none in the anterior groups. There were no outliers > 10° in anterior or posterior for abduction in all surgeons. The SSP had six outliers > 10° in anteversion while the NSP had none (p = 0.004); the SSA had no outliers for anteversion while the NSA had one (p = 0.500). Conclusion Robotic arm-assisted technology allowed a newly trained surgeon to produce similarly accurate results and outcomes as experienced surgeons in anterior and posterior hip arthroplasty. Cite this article: Bone Jt Open 2021;2(6):365–370.


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