Robotic arm-assisted total hip arthroplasty via a minimally invasive anterolateral approach in the supine position improves the precision of cup placement in patients with developmental dysplasia of the hip

Tamaki, Yasuhiro; Goto, Tomohiro; Wada, Keizo; Omichi, Yasuyuki; Hamada, Daisuke; Sairyo, Koichi

doi:10.1016/j.jos.2023.01.012

Cited by 3 publications

(3 citation statements)

References 26 publications

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“…Comparing CT-based navigation and robotic-arm assisted systems, Tamaki et al. [ 10 ] reported that the absolute error of RI and RA was smaller in robotic-arm assisted THA, which supports our study findings. The robotic arm–assisted system can control the cup impactor to the planned angle during installation, which may contribute to the accuracy of cup orientation [ 32 ].…”

Section: Discussionsupporting

confidence: 90%

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Robotic Arm–Assisted System Improved Accuracy of Cup Position and Orientation in Cementless Total Hip Arthroplasty for Dysplastic Hips: A Comparison Among Groups With Manual Placement, Computed Tomography–Based Navigation, and Robotic Surgery

Konishi,

Sato,

Hamai

et al. 2024

Arthroplasty Today

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Section: Discussionsupporting

confidence: 90%

“…Although there have been several reports investigating the accuracy of cup orientation and position in THA for patients with dysplasia through robotic-arm assisted THA (R-THA), CT-based navigated THA (N-THA), and manual THA (M-THA), [ [8] , [9] , [10] ] only a limited number of studies have compared the accuracy of the 3 procedures.…”

Section: Introductionmentioning

confidence: 99%

Robotic Arm–Assisted System Improved Accuracy of Cup Position and Orientation in Cementless Total Hip Arthroplasty for Dysplastic Hips: A Comparison Among Groups With Manual Placement, Computed Tomography–Based Navigation, and Robotic Surgery

Konishi,

Sato,

Hamai

et al. 2024

Arthroplasty Today

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“…The literature on the use of robotic-assisted THA in patients with DDH demonstrates improved component positioning in comparison to navigated and manual methods [2,5,11], although studies with long-term follow-up in this patient population are lacking. A retrospective review of 79 DDH patients who underwent robotic-assisted THA revealed significant improvements in Harris Hip Scores and significant decreases in leg length discrepancies, with no dislocations, fractures, or revisions at an average of 3 years postoperatively [12].…”

Section: A Case Of Bilateral Ddhmentioning

confidence: 99%

Correcting Hip Dysplasia in Young Adults: Intraoperative Navigation and Outcomes

Ondeck,

Borsinger,

Chalmers

et al. 2023

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Developmental dysplasia of the hip (DDH) often leads to characteristic acetabular dysplasia and typical femoral anomalies. There are numerous treatments for skeletally mature patients with DDH including hip arthroscopy, pelvic and femoral osteotomies, as well as total hip arthroplasty. Before proceeding to an arthroplasty procedure, it can be helpful to obtain an opinion of a hip preservation specialist to ascertain if alternative surgical treatments could contribute to the patient’s care. In general, the use of robotic navigation has been associated with a higher proportion of cups placed in the Lewinnek safe zone, larger improvements in Harris Hip Scores, and no difference in overall complication rates in comparison to manual total hip arthroplasty. The use of robotic navigation allows for both 2-dimensional and 3-dimensional preoperative templating, enabling the surgeon to plan the position of the construct such that it achieves maximum bony purchase and hip stability. In complex DDH cases, surgeons can work with a biomechanics department to complete a fit check assessment, which utilizes 3-dimensional templating software to ascertain the appropriateness of the implant’s geometry with the patient’s anatomy. Furthermore, a 3-dimensional printed plastic model of the pelvis and/or femur can be constructed in order to complete a rehearsal procedure, which may be particularly helpful for those cases involving osteotomies. The literature on the use of robotic-assisted total hip arthroplasty in patients with DDH demonstrates improved component positioning in comparison to navigated as well as manual methods; however, studies with long-term follow-up in this patient population are lacking.

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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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Robotic arm-assisted total hip arthroplasty via a minimally invasive anterolateral approach in the supine position improves the precision of cup placement in patients with developmental dysplasia of the hip

Cited by 3 publications

References 26 publications

Robotic Arm–Assisted System Improved Accuracy of Cup Position and Orientation in Cementless Total Hip Arthroplasty for Dysplastic Hips: A Comparison Among Groups With Manual Placement, Computed Tomography–Based Navigation, and Robotic Surgery

Robotic Arm–Assisted System Improved Accuracy of Cup Position and Orientation in Cementless Total Hip Arthroplasty for Dysplastic Hips: A Comparison Among Groups With Manual Placement, Computed Tomography–Based Navigation, and Robotic Surgery

Correcting Hip Dysplasia in Young Adults: Intraoperative Navigation and Outcomes

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

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