Robotic total hip arthroplasty: past, present and future

Fontalis, Andreas; Kayani, Babar; Thompson, Joshua W.; Plastow, Ricci; Haddad, Fares S.

doi:10.1016/j.mporth.2021.11.002

Cited by 21 publications

(14 citation statements)

References 21 publications

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“…Gaining an in-depth understanding of the necessary parameters to evaluate spinopelvic mobility and recognising the individual patterns of imbalance and ramifications is vital for the arthroplasty surgeon. Robotic arm–assisted THA offers a pragmatic and reproducible way to achieve the desired implant orientation, in addition to offset and leg length [ 32 ]—all very important surgical targets especially in the subset of patients with spinopelvic imbalance. Furthermore, the introduction of the latest software allowing virtual ROM is a valuable tool in the surgical armamentarium, providing real-time pre-operative and intra-operative feedback regarding ROM and the presence of impingement.…”

Section: Discussionmentioning

confidence: 99%

Functional implant positioning in total hip arthroplasty and the role of robotic-arm assistance

Fontalis

Raj

Kim

et al. 2022

International Orthopaedics (SICOT)

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Introduction Accurate implant positioning, tailored to the phenotype and unique biomechanics of each patient is the single most important objective in achieving stability in THA and maximise range of motion. The spine-pelvis-hip construct functions as a single unit adapting to postural changes. It is widely accepted in the literature that no universaltarget exists and variations in spinopelvic mobility mandate adjustments to the surgical plan; thus bringing to the fore the concept of personalised, functional component positioning. Methods This manuscript aims to outline the challenges posed by spinopelvic imbalance and present a reproducible, stepwise approach to achieve functional-component positioning. We also present the one-year functional outcomes and Patient Reported Outcome Measures of a prospective cohort operated with this technique. Results and Conclusion Robotic-arm assisted Total Hip Arthroplasty has facilitated enhanced planning based on the patient’s phenotype and evidence suggests it results in more reproducible and accurate implant positioning. Preservation of offset, avoiding leg-length discrepancy, accurate restoration of the centre of rotation and accomplishing the combinedversion target are very important parameters in Total Hip Arthroplasty that affect post-operative implant longevity, patient satisfaction and clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Functional implant positioning in total hip arthroplasty and the role of robotic-arm assistance

Fontalis

Raj

Kim

et al. 2022

International Orthopaedics (SICOT)

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“…The opinion of the authors of this review is that in the future, studies and reviews should focus on making a discrete distinction between active and semi-active robotic assistance, addressing technology matureness, and considering surgeon experience. Clear limitations of RO THA include the additional radiation exposure and associated hazards and the high costs related to the installation, computer software, pre-operative imaging, operational costs, surgical team training, learning curves, and the limited amount of compatible implants [19,20]. However, it has been suggested that additional costs could be balanced by the reduced length of stay, fewer complications, and longer implant survivorship [21,22].…”

Section: B Semiactive Robotic Systemsmentioning

confidence: 99%

The Top Three Burning Questions in Total Hip Arthroplasty

et al. 2023

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Total hip arthroplasty (THA) for end-stage osteoarthritis is one of the most effective surgical treatments in medicine. Impressive outcomes have been well documented in the literature with patients gaining ambulation and recovery of hip joint function. Nevertheless, there are still debatable issues and controversies that the orthopedic community has not been able to provide a definitive answer for. This review is focused on the current three most debatable issues surrounding the THA procedure: (1) new cutting-edge technology, (2) spinopelvic mobility, and (3) fast-track protocols. The scope of the herein narrative review is to analyze the debatable issues surrounding the three aforementioned topics and conclude the best contemporary clinical approaches regarding each issue.

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“…Computer-assisted navigation and robotics have been increasingly used in THA; compared with manual methods, these tools can improve reproducibility of component positioning and provide quantitative intraoperative information on leg length and offset [7,62]. For platforms that use preoperative 3-dimensional imaging, impingement modeling further allows for optimization of implant positioning based on patient factors [31]. This information, combined with the ability to precisely position implants, has the potential to improve implant longevity with enhanced restoration of hip mechanics as well as decreased edge loading, soft tissue irritation from prominent hardware, bony and implant impingement, and instability [31].…”

Section: Computer Navigation and Robotics In Thamentioning

confidence: 99%

Total Hip Arthroplasty: An Update on Navigation, Robotics, and Contemporary Advancements

Borsinger,

Chandi,

Puri

et al. 2023

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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While total hip arthroplasty (THA) remains effective for improvement of pain and function in patients with osteoarthritis and avascular necrosis, there remain areas of continued pursuit of excellence, including decreasing rates of dislocation, leg length discrepancy, implant loosening, and infection. This review article covers several bearing surfaces and articulations, computer-assisted navigation and robotic technology, and minimally invasive surgical approaches that have sought to improve such outcomes. Perhaps the most significant improvement to THA implant longevity has been the broad adoption of highly cross-linked polyethylene, with low wear rates. Similarly, navigation and robotic technology has proven to more reproducibly achieve intraoperative component positioning, which has demonstrated clinical benefit with decreased risk of dislocation in a number of studies. Given the projected increase in THA over the coming decades, continued investigation of effective incorporation of technology, soft tissue–sparing approaches, and durable implants is imperative to continued pursuit of improved outcomes in THA.

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Robotic total hip arthroplasty: past, present and future

Cited by 21 publications

References 21 publications

Functional implant positioning in total hip arthroplasty and the role of robotic-arm assistance

Functional implant positioning in total hip arthroplasty and the role of robotic-arm assistance

The Top Three Burning Questions in Total Hip Arthroplasty

Total Hip Arthroplasty: An Update on Navigation, Robotics, and Contemporary Advancements

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