Effectiveness of the ROBODOC System during Total Hip Arthroplasty in Preventing Intraoperative Pulmonary Embolism

Abstract

Abstract. Intraoperative pulmonary embolism can occur not only during cemented total hip arthroplasty (THA) but also during cementless THA. In the present study, we demonstrated the usefulness of the ROBODOC femoral milling system in reducing intraoperative pulmonary embolism, as indicated by results of transesophageal echocardiography and hemodynamic monitoring. A prospective clinical trial was conducted with 58 patients (60 hips) who were randomly divided into 2 groups: group 1, 38 patients (40 hips) who underwent cementless THA with preparation of the femoral canal using ROBODOC; group 2, 20 patients (20 hips) who underwent conventional manual cementless THA surgery. During femoral preparation, severe embolic events were observed at a significantly lower frequency in group 1 (0%) than in group 2 (30%) (p<0.0001). During stem insertion, incidence of severe embolic events was significantly lower in group 1 (0%) than in group 2 (20%) (p<0.0001). Moreover, during hip relocation, incidence of severe embolic events was significantly lower in group 1 (8%) than in group 2 (45%) (p<0.0001). The ROBODOC system decreased the incidence of severe embolic events during femoral preparation, resulting in low incidence of severe events during stem insertion and hip relocation. The present results suggest that the ROBODOC femoral milling system may reduce the risk of pulmonary embolism during cementless THA.

Design and performance study of an orthopaedic surgery robotized module for automatic bone drilling

“…All of this affects the patient's safety, which is of crucial importance (22). The first commercially available robotized CAOS systems were ROBODOC, CASPAR, and ACROBOT (1)(2)(3)(4)(5)(6)17). ROBODOC was the first robot developed for total hip arthoplasty.…”

“…Because orthopaedic screws are often implanted in bones, it is necessary to perform bone drilling beforehand . Yet, manual drilling tends to produce such problems as apertures larger than needed, tendon or blood vessel breaks, and overheating , which affect the accuracy and safety of the operation. In , a total of 462 bicortical manoeuvres were analyzed, and the average projection of the drill bit beyond the far cortex was found to be 6.31 mm.…”

“…It enables the surgeon to pre‐operatively plan the alignment and placement of knee resurfacing implants and intra‐operatively and accurately sculpt complex, anatomic, tissue‐sparing, and bone‐conserving cuts . These robots have been installed in many hospitals, where they have been used to perform numerous successful surgical procedures . MIRO is a new versatile lightweight robot for surgical application .…”