Accuracy and Precision of Acetabular Component Position Does Not Differ Between the Anterior and Posterior Approaches to Total Hip Arthroplasty With Robotic Assistance: A Matched-Pair Analysis

Kunze, Kyle N.; Huddleston, Hailey P.; Romero, Joey; Chiu, Yu-Fen; Jerabek, Seth A.; McLawhorn, Alexander S.

doi:10.1016/j.artd.2022.08.004

Cited by 10 publications

(2 citation statements)

References 40 publications

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“…Some joint surgeons are concerned about whether the difficulty associated with the direct anterior approach can lead to poor placement of the prosthesis, leading to a series of surgical complications [8,9]. However, controversy remains over whether direct anterior hip arthroplasty can attain a better hip prosthesis position than other techniques, and whether it can maintain a good prosthesis position on a long-term basis [10][11][12][13]. Our institute is one of the earliest in China to introduce the direct anterior approach hip arthroplasty and has been performing the procedure for over 15 years.…”

Section: Introductionmentioning

confidence: 99%

Radiographic study of direct anterior approach hip arthroplasty: a 10–15 year follow-up of Chinese patients

Sang,

Lai,

et al. 2024

Arthroplasty

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Background Controversy remains over whether different surgical approaches exert an impact on the component positioning in total hip arthroplasty. We conducted a retrospective study to reveal the long-term position of prostheses in the first group of patients in China who underwent direct anterior hip arthroplasty. Methods Collected were data from 350 patients who underwent direct anterior hip arthroplasty between 2008 and 2013, including demographic information, imaging data, Harris hip scores, and surgical complications. Variables, measured radiographically or by CT, included hip offset, leg length discrepancy, component position, and stability within one week after surgery and at the last follow-up. The data were subjected to statistical analysis by using paired t-tests and Pearson chi-square tests. Results Data were harvested by follow-up and self-reported questionnaires. The postoperative follow-up lasted for 13.1 years on average (minimum, 10 years; maximum, 15 years), and the overall survival rate of hip prostheses was 96.3%. The mean Harris score at the final follow-up was 91.8 points. After excluding patients with significant preoperative hip deformities, the incidence of postoperative limb inequality (> 5 mm) was 4.9% at the last follow-up, and the incidence of hip offset discrepancy (> 5 mm) was 14.6%. The overall proportion of the acetabular components located in the Lewinnek safe zone was 77.7%, whereas the proportion of femoral prostheses in the safe zone (< 3° inclination) was 94.0%. Based on the revised data and the last follow-up imaging, the total proportion of acetabular and femoral prostheses with a radiolucence of > 2 mm was 5.1%. Conclusion Direct anterior approach hip arthroplasty could achieve excellent component positioning and long-term prosthesis survival in patients without severe hip deformities.

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Section: Introductionmentioning

confidence: 99%

Radiographic study of direct anterior approach hip arthroplasty: a 10–15 year follow-up of Chinese patients

Sang,

Lai,

et al. 2024

Arthroplasty

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“…However, only a few reports have compared robotic arm-assisted surgery with CT-based navigated THA [6, 17,18]. Moreover, in previous studies, differences in the surgical approach affected cup orientation with and without the Mako systems [19,20]. To our knowledge, no reports have compared robotic arm-assisted THA (rTHA) to CT-based navigated THA (nTHA) using the direct anterior approach (DAA) in the supine position.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of robotic arm-assisted versus computed tomography-based navigation for cup orientation and positioning in total hip arthroplasty using the direct anterior approach in supine position

Okazaki

Imagama

Matsuki

et al. 2023

Preprint

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Background A robotic arm-assisted and a computed tomography (CT)-based navigation system have been reported to improve the accuracy of component positioning in total hip arthroplasty (THA). Although some previous studies have compared robotic arm-assisted THA (rTHA) with CT-based navigated THA (nTHA), most studies evaluated the outcomes in the lateral position. No study has compared rTHA to nTHA concerning accuracy of cup placement and acetabular fractures using the direct anterior approach (DAA) in supine position. This study aimed to compare the accuracy of cup placement and the presence of intraoperative acetabular fractures between rTHA and nTHA using DAA in supine position. Methods We retrospectively investigated 209 hips of 188 patients who underwent rTHA or nTHA using DAA in supine position (rTHA using the Mako system: 85 hips of 79 patients; nTHA: 124 hips of 109 patients). After propensity score matching for age and sex, each group consisted of 73 hips. Postoperative cup orientation and positions measured using a three-dimensional templating software were compared to preoperative planning with CT measurements. Additionally, we investigated the prevalence of occult acetabular fracture. Results The mean absolute error of cup orientation was significant smaller in the rTHA group than in nTHA (inclination: 1.4° ± 1.2° vs 2.7° ± 2.2°, respectively; p = 0.0001, anteversion: 1.5° ± 1.3° vs 2.2° ± 1.7°, respectively; p = 0.007). The cases within an absolute error of 5 degrees in both RI and RA were significantly higher in the rTHA (97.3%) than in nTHA group (82.2%) (p = 0.003). The absolute error of the cup position was not significantly different between the two groups. The prevalence of occult acetabular fracture did not differ significantly between the two groups (rTHA: n = 0 [0%] vs. nTHA: n = 1 [1.4%]). Conclusion Cup placement using DAA in the supine position in rTHA was more accurate with fewer outliers compared to nTHA. Therefore, rTHA performed via DAA in a supine position would be useful for accurate cup placement.

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Influence of obesity and intra-operative imaging guidance technology on acetabular cup positioning in total hip arthroplasty

Luu

Nishioka

Lawton

et al. 2023

Arch Orthop Trauma Surg

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Accuracy and Precision of Acetabular Component Position Does Not Differ Between the Anterior and Posterior Approaches to Total Hip Arthroplasty With Robotic Assistance: A Matched-Pair Analysis

Cited by 10 publications

References 40 publications

Radiographic study of direct anterior approach hip arthroplasty: a 10–15 year follow-up of Chinese patients

Radiographic study of direct anterior approach hip arthroplasty: a 10–15 year follow-up of Chinese patients

Accuracy of robotic arm-assisted versus computed tomography-based navigation for cup orientation and positioning in total hip arthroplasty using the direct anterior approach in supine position

Influence of obesity and intra-operative imaging guidance technology on acetabular cup positioning in total hip arthroplasty

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