Frühergebnisse einer prospektiven Studie bei Patienten mit computergestützter Femurschaftpräparation bei Hüft-TEP-Implantationen (System Robodoc) - Indikation, Ergebnisse, Komplikationen

Abstract

Generally, Robodoc-assisted surgery may be performed in all uncemented total hip arthroplasties. The individual indication should be checked because of the increased effort of surgery, the advantages and disadvantages, and the non-proven better long-term results in comparison to the regular technique. It seems that the Robodoc system provides advantages in post-traumatic arthritis and deformities of the proximal femur (varus and valgus neck) on account of the computer-aided preoperative planning and correct operative realization.

Early loosening of hip replacements: causes, course and diagnosis

“…The frequently encountered thesis that the majority of cementless stem prostheses subside initially and that this is a favourable development for a more intensive bone-implant contact cannot be upheld in view of the current literature. At the same time there is no proof that enlargement of the bone-implant contact surface as such effects a significant improvement in secondary stability [8,23,37]. At this early stage, the effect of wear particles seems still to be of subordinate importance.…”

“…There are, however, more and more indications that implantation of stem prostheses by surgical robots (Robodoc or Caspar) -besides the lack of scientific evaluation (unproven improvement in prosthesis survival in comparison to prostheses implanted by conventional methods) -does have unfavourable effects and results in a greater number of complications [36,37]. These include: -Operation planning is more time-consuming and workintensive -Operation time is doubled -The cost of purchasing and operating the systems is high -Patients suffer greater loss of blood -Radiation exposure due to (in some cases repeated) preoperative computer tomography -Two operations and anaesthesia procedures are used when marking pins (titanium screws) -Pin loosening or malpositioning -Pain at the medial condyle caused by pins -Larger amount of soft tissue exposure or detachment -The pelvic-trochanteric musculature is weakened -Trochanter discrimination -The risk of thrombosis and embolism is increased due to the tight fixation of the leg -Miscalculations due to patient movement -The systems cannot be used in obese patients (approach).…”

Klinisches Outcome nach Roboter-assistierter versus konventionell implantierter Hüftendoprothetik: Prospektive, kontrollierte Untersuchung von 71 Patienten

“…Infolge der durch den Roboter erzielten höheren Passgenauigkeit des Prothesenschafts [2, 6 -8] und der resultierenden größeren Primärstabilität [9 -11] seien daher verbesserte Langzeitergebnisse im Vergleich zur herkömmlichen Hüftendoprothetik zu erwarten [2 -4, 12]. Zugleich böte die exakte und reliable OP-Planung gerade bei angeborenen und erworbenen Deformitäten des koxalen Femurs Vorteile gegenüber dem konventionellen Verfahren [13,14].…”

Housing design and testing of a surgical robot developed for orthopaedic surgery

“…Such surgery-assisting technology is appreciated by surgeons as it provides accurate geometrical positioning and exact predefined exerting forces that grant more precise surgical therapy to patients. daVinci ® is a leading brand in surgical robotics; its success can be attributed to its tele-manipulator architecture that is applicable to many minimally invasive surgeries, achieving satisfactory outcomes [7] , [8] . In orthopaedic surgery, there is demand for a surgical tool that can be manipulated accurately and stably to the expected position/orientation on a target, e.g., to target on bone during bone resection.…”