Is Robotic Arm Assisted Total Hip Arthroplasty More Bone Preserving than Conventional Hip Replacements and Hip Resurfacing?

Gunaratne, Rajitha; Levy, Ben; D’Souza, Harry; Taheri, Arash

doi:10.4236/ojo.2022.126025

Cited by 1 publication

(2 citation statements)

References 24 publications

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Section: Introductionmentioning

confidence: 99%

“…Modern‐day materials and manufacturing processes, combined with navigation and robotics technology, has resulted in many surgeons moving away from the traditional philosophy defined more than half a century ago of medialising the cup to achieve initial fixation. 16 , 17 , 18 These surgeons typically aim to restore the native centre of rotation and femoral offset, while preserving acetabulum bone stock. However, the consequence is that patients may not benefit from the biomechanical advantage of medialising the cup, which can have a significant effect of abductor muscle and joint contact forces.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The effect of surgical change to hip geometry on hip biomechanics after primary total hip arthroplasty

Bahl

Arnold

Saxby

et al. 2022

Journal Orthopaedic Research

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The aim of this study was to determine the effect of surgical change to the acetabular offset and femoral offset on the abductor muscle and hip contact forces after primary total hip arthroplasty (THA) using computational methods. Thirty-five patients undergoing primary THA were recruited. Patients underwent a computed tomography scan of their pelvis and hip, and underwent gait analysis pre-and 6-months postoperatively. Surgically induced changes in acetabular and femoral offset were used to inform a musculoskeletal model to estimated abductor muscle and hip joint contact forces. Two experiments were performed: (1) influence of changes in hip geometry on hip biomechanics with preoperative kinematics; and (2) influence of changes in hip geometry on hip biomechanics with postoperative kinematics. Superior and medial placement of the hip centre of rotation during THA was most influential in reducing hip contact forces, predicting 63% of the variance (p < 0.001). When comparing the preoperative geometry and kinematics model, with postoperative geometry and kinematics, hip contact forces increased after surgery (0.68 BW, p = 0.001). Increasing the abductor lever arm reduced abductor muscle force by 28% (p < 0.001) and resultant hip contact force by 17% (0.6 BW, p = 0.003), with both preoperative and postoperative kinematics. Failure to increase abductor lever arm increased resultant hip contact force 11% (0.33 BW, p < 0.001). In conclusion, increasing the abductor lever arm provides a substantial biomechanical benefit to reduce hip abductor and resultant hip joint contact forces. The magnitude of this effect is equivalent to the average increase in hip contact force seen with improved gait from pre-to post-surgery.

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Section: Introductionmentioning

confidence: 99%