The current role of robotics in total hip arthroplasty

Abstract

Robotic total hip arthroplasty (THA) improves accuracy in achieving the planned acetabular cup positioning compared to conventional manual THA. Robotic THA improves precision and reduces outliers in restoring the planned centre of hip rotation compared to conventional manual THA. Improved accuracy in restoring hip biomechanics and acetabular cup positioning in robotic THA have not translated to any differences in early functional outcomes, correction of leg-length discrepancy, or postoperative complications compared to conventional manual THA. Limitations of robotic THA include substantive installation costs, additional radiation exposure, steep learning curves for gaining surgical proficiency, and compatibility of the robotic technology with a limited number of implant designs. Further higher quality studies are required to compare differences in conventional versus robotic THA in relation to long-term functional outcomes, implant survivorship, time to revision surgery, and cost-effectiveness. Cite this article: EFORT Open Rev 2019;4:618-625. DOI: 10.1302/2058-5241.4.180088

Robotics in total hip arthroplasty: a review of the evolution, application and evidence base

“… 11 – 14 Robotic-assisted orthopaedic surgery has the potential to improve the accuracy of component positioning in THA, thus, enhancing clinical outcomes. 15 , 16 This review aims to summarize the history and development of robotic technology in orthopaedic surgery, and discuss the evidence base surrounding its use.…”

“…An instant shut-off switch was available to the surgeon if required. 15 In recent years, semi-active robotic systems have become increasingly popular. 15 , 20 These systems require the surgeon to guide the robotic arm for bony preparation via a haptic feedback mechanism that ensures minimal deviation from the pre-determined surgical plan.…”

“… 15 In recent years, semi-active robotic systems have become increasingly popular. 15 , 20 These systems require the surgeon to guide the robotic arm for bony preparation via a haptic feedback mechanism that ensures minimal deviation from the pre-determined surgical plan. Additionally, these systems have the capability to provide real-time information on femoral preparation to allow corrections to be made intra-operatively.…”

Precision and accuracy of robot‐assisted technology with simplified express femoral workflow in measuring leg length and offset in total hip arthroplasty

“…Recently, with the introduction of semi‐active, haptic robotic systems, there has been renewed interest in robotic devices for THA 2,3 . In semi‐active robot‐assisted THA, the acetabular preparation and implantation are performed with the assistance of a robotic arm.…”

Computerised tomography-based planning with conventional total hip arthroplasty versus robotic-arm assisted total hip arthroplasty: study protocol for a prospective randomised controlled trial

“…However, further studies have shown no difference in CO THA versus RO THA with respect to functional outcomes, implant survivorship, and complications at short-term follow-up [4,17,19,21]. Delays in the widespread implementation of RO THA have been attributed to the limited data showing any functional benefit with this procedure compared to an already established and highly cost-effective CO THA [7,13].…”