Robotic-arm assisted THA can achieve precise cup positioning in developmental dysplasia of the hip

Abstract

Aims This study aimed to evaluate the accuracy of implant placement with robotic-arm assisted total hip arthroplasty (THA) in patients with developmental dysplasia of the hip (DDH). Methods The study analyzed a consecutive series of 69 patients who underwent robotic-arm assisted THA between September 2018 and December 2019. Of these, 30 patients had DDH and were classified according to the Crowe type. Acetabular component alignment and 3D positions were measured using pre- and postoperative CT data. The absolute differences of cup alignment and 3D position were compared between DDH and non-DDH patients. Moreover, these differences were analyzed in relation to the severity of DDH. The discrepancy of leg length and combined offset compared with contralateral hip were measured. Results The mean values of absolute differences (postoperative CT-preoperative plan) were 1.7° (standard deviation (SD) 2.0) (inclination) and 2.5° (SD 2.1°) (anteversion) in DDH patients, and no significant differences were found between non-DDH and DDH patients. The mean absolute differences for 3D cup position were 1.1 mm (SD 1.0) (coronal plane) and 1.2 mm (SD 2.1) (axial plane) in DDH patients, and no significant differences were found between two groups. No significant difference was found either in cup alignment between postoperative CT and navigation record after cup screws or in the severity of DDH. Excellent restoration of leg length and combined offset were achieved in both groups. Conclusion We demonstrated that robotic-assisted THA may achieve precise cup positioning in DDH patients, and may be useful in those with severe DDH. Cite this article: Bone Joint Res 2021;10(10):629–638.

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

“…To examine the accuracy of the cup position, the absolute errors of the HCOR and VCOR and the proportion of hips within 3 mm of the target were compared [ 22 , 23 ]. For cup orientation, we compared the absolute errors of RI and RA, as well as the proportion of hips within 5° of the target [ 24 , 25 ]. All measurements were conducted by the first author (T.K.…”

Robotic-assisted Total Hip Arthroplasty and Spinopelvic Parameters: A Review

“…Numerous cases involving utilization of robotic-arm-assisted THA (rTHA) in complex THA such as developmental dysplasia of the hip, ankylosing spondylolysis, and post-traumatic arthritis have been reported. These reports have demonstrated excellent functional outcomes and improved positioning of the acetabular implant when compared with similar cases performed without navigation [38][39][40][41][42][43] . Fig.…”

Segmental Acetabular Defects Managed by Augments in Conjunction with CT During Robotic Total Hip Arthroplasty

“…It has been shown to be particularly beneficial in complex cases. [7][8][9][10] Treating hip dysplasia, including with the robotic platform, to improve component coverage with the high hip center (HHC) technique has been described 7,8 . Alternatively, maintaining the anatomic center with augmentation is also an established alternative that has excellent mid-term survivorship 11,12 .…”