A Comparison between Robotic-assisted and Manual Implantation of Cementless Total Hip Arthroplasty

Nakamura, N.; Sugano, Nobuhiko; Nishii, Takashi; Kakimoto, Akihiro; Miki, Hirokazu

doi:10.1007/s11999-009-1158-2

Cited by 127 publications

(114 citation statements)

References 17 publications

Supporting

Mentioning

112

Contrasting

Order By: Relevance

“…8 For the most part, these techniques appear to be at least comparable to conventional technique in terms of accuracy. 10,25 Robotic surgery, which has already been used routinely in other specialties, 7,14,16,26 only recently gained acceptance in spinal surgery.…”

mentioning

confidence: 99%

Robotic versus fluoroscopy-guided pedicle screw insertion for metastatic spinal disease: a matched-cohort comparison

Solomiichuk¹,

Fleischhammer

Molliqaj

et al. 2017

Neurosurgical Focus

125

View full text Add to dashboard Cite

OBJECTIVERobot-guided pedicle screw placement is an established technique for the placement of pedicle screws. However, most studies have focused on degenerative disease. In this paper, the authors focus on metastatic spinal disease, which is associated with osteolysis. The associated lack of dense bone may potentially affect the automatic recognition accuracy of radiography-based surgical assistance systems. The aim of the present study is to compare the accuracy of the SpineAssist robot system with conventional fluoroscopy-guided pedicle screw placement for thoracolumbar metastatic spinal disease.METHODSSeventy patients with metastatic spinal disease who required instrumentation were included in this retrospective matched-cohort study. All 70 patients underwent surgery performed by the same team of experienced surgeons. The decision to use robot-assisted or fluoroscopy-guided pedicle screw placement was based the availability of the robot system. In patients who underwent surgery with robot guidance, pedicle screws were inserted after preoperative planning and intraoperative fluoroscopic matching. In the “conventional” group, anatomical landmarks and anteroposterior and lateral fluoroscopy guided placement of the pedicle screws. The primary outcome measure was the accuracy of screw placement on the Gertzbein-Robbins scale. Grades A and B (< 2-mm pedicle breach) were considered clinically acceptable, and all other grades indicated misplacement. Secondary outcome measures included an intergroup comparison of direction of screw misplacement, surgical site infection, and radiation exposure.RESULTSA total of 406 screws were placed at 206 levels. Sixty-one (29.6%) surgically treated levels were in the upper thoracic spine (T1–6), 74 (35.9%) were in the lower thoracic spine, and the remaining 71 (34.4%) were in the lumbosacral region. In the robot-assisted group (Group I; n = 35, 192 screws), trajectories were Grade A or B in 162 (84.4%) of screws. The misplacement rate was 15.6% (30 of 192 screws). In the conventional group (Group II; n = 35, 214 screws), 83.6% (179 of 214) of screw trajectories were acceptable, with a misplacement rate of 16.4% (35 of 214). There was no difference in screw accuracy between the groups (chi-square, 2-tailed Fisher’s exact, p = 0.89). One screw misplacement in the fluoroscopy group required a second surgery (0.5%), but no revisions were required in the robot group. There was no difference in surgical site infections between the 2 groups (Group I, 5 patients [14.3%]; Group II, 8 patients [22.9%]) or in the duration of surgery between the 2 groups (Group I, 226.1 ± 78.8 minutes; Group II, 264.1 ± 124.3 minutes; p = 0.13). There was also no difference in radiation time between the groups (Group I, 138.2 ± 73.0 seconds; Group II, 126.5 ± 95.6 seconds; p = 0.61), but the radiation intensity was higher in the robot group (Group I, 2.8 ± 0.2 mAs; Group II, 2.0 ± 0.6 mAs; p < 0.01).CONCLUSIONSPedicle screw placement for metastatic disease in the thoracolumbar spine can be performed effectively and safely using robot-guided assistance. Based on this retrospective analysis, accuracy, radiation time, and postoperative infection rates are comparable to those of the conventional technique.

show abstract

mentioning

confidence: 99%

Robotic versus fluoroscopy-guided pedicle screw insertion for metastatic spinal disease: a matched-cohort comparison

Solomiichuk¹,

Fleischhammer

Molliqaj

et al. 2017

Neurosurgical Focus

125

View full text Add to dashboard Cite

show abstract

“…[9][10][11][12][13][14][15][16][17] Furthermore, robotic-assisted THA had more reproducible clinical outcomes with significantly less limb length variance. 7,10,13,14 Overall, the robotic-assisted THA had significantly better femoral component fit and fill compared to controls.…”

Section: Resultsmentioning

confidence: 98%

“…[7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] Twelve of the 15 articles were clinical studies. In these 12 studies, a total of 682 patients underwent THA using ROBODOC ® and 50 patients underwent THA using MAKOplasty ® .…”

Section: Methodsmentioning

confidence: 99%

“…The combined mean follow-up time for all studies was 26.35 months (range, 1-67). [7][8][9][10][11][12][13]15,[17][18][19]21 The remaining three studies were cadaveric studies, where a total of 15 cadavers had components placed with the ROBODOC ® and 6 cadavers had components placed using the MAKOplasty ® .…”

Section: Methodsmentioning

confidence: 99%

“…7,8 Proponents of robotic-assisted THA argue that despite the increased cost and complication rate, better long-term results and more accurate component positioning have been seen with roboticassisted THA. [9][10][11][12][13][14][15][16][17] The purpose of this study was to analyze two different US Food and Drug Administration (FDA) approved robotic devices that are currently used in primary THA. We evaluated 1) accuracy of component placement, 2) reproducibility of the procedure, 3) limb alignment 4) clinical outcomes of THA, 5) and complications associated with robotic-assisted THA.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Robotic-assisted total hip arthroplasty: a critical appraisal

Newman¹,

Carroll²,

Cross³

2014

RSRR

View full text Add to dashboard Cite

Improvements in implant design, surgical technique, and technology have decreased the incidence of complications following a total hip arthroplasty (THA). Robotic-assisted surgery is one technological advance that has improved the reproducibility and accuracy of component placement by customizing the procedure based on the patient's anatomy. However, the learning curve, additional imaging that is required, intraoperative and postoperative complications, and the cost have prevented the widespread use of robotics.

show abstract

Research quality and transparency, outcome measurement and evidence for safety and effectiveness in robot-assisted surgery: systematic review

et al. 2020

View full text Add to dashboard Cite

Background: Robot-assisted surgery (RAS) has potential panspecialty surgical benefits. High-quality evidence for widespread implementation is lacking. This systematic review aimed to assess the RAS evidence base for the quality of randomized evidence on safety and effectiveness, specialty 'clustering', and outcomes for RAS research. Methods: A systematic review was undertaken according to PRISMA guidelines. All pathologies and procedures utilizing RAS were included. Studies were limited to RCTs, the English language and publication within the last decade. The main outcomes selected for the review design were safety and efficacy, and study purpose. Secondary outcomes were study characteristics, funding and governance. Results: Searches identified 7142 titles, from which 183 RCTs were identified for data extraction. The commonest specialty was urology (35⋅0 per cent). There were just 76 unique study populations, indicating significant overlap of publications; 103 principal studies were assessed further. Only 64⋅1 per cent of studies reported a primary outcome measure, with 29⋅1 per cent matching their registration/protocol. Safety was assessed in 68⋅9 per cent of trials; operative complications were the commonest measure. Forty-eight per cent of trials reported no significant difference in safety between RAS and comparator, and 11 per cent reported RAS to be superior. Efficacy or effectiveness was assessed in 80⋅6 per cent of trials; 43 per cent of trials showed no difference between RAS and comparator, and 24 per cent reported that RAS was superior. Funding was declared in 47⋅6 per cent of trials. Conclusion: The evidence base for RAS is of limited quality and variable transparency in reporting. No patterns of harm to patients were identified. RAS has potential to be beneficial, but requires continued high-quality evaluation.

show abstract

A Comparison between Robotic-assisted and Manual Implantation of Cementless Total Hip Arthroplasty

Cited by 127 publications

References 17 publications

Robotic versus fluoroscopy-guided pedicle screw insertion for metastatic spinal disease: a matched-cohort comparison

Robotic versus fluoroscopy-guided pedicle screw insertion for metastatic spinal disease: a matched-cohort comparison

Robotic-assisted total hip arthroplasty: a critical appraisal

Research quality and transparency, outcome measurement and evidence for safety and effectiveness in robot-assisted surgery: systematic review

Contact Info

Product

Resources

About