Robotic systems in total hip arthroplasty – is the time ripe for a new approach?

Abstract

The technical aspects of manual total hip arthroplasty are briefly described. The development, technique and technical problems of previous robotic systems in total hip arthroplasty are described with special details of the Robodoc--System. Recent advances regarding the minimally invasive technique of total-hip implantation and navigation are described. The current development of a robotic assisted system for total hip arthroplasty is presented. This project aims to combine the advantages of minimally invasive techniques and navigational systems with the accuracy that robotic assisted bone milling can provide. The project-name is RomEo (Robotic minimally invasive Endoprosthetics), the main project partners are the Helmut-Schmidt-University/Hamburg and the Department of Trauma and Orthopaedics of the BG Trauma Hospital Hamburg.

Results of total hip replacement using the Robodoc surgical assistant system: clinical outcome and evaluation of complications for 97 procedures

“…The first clinical use in Germany took place in the summer of 1994 at the Berufsgenossenschaftliche Unfallklinik (BGU) in Frankfurt (2). In the subsequent 10 years the Robodoc system has sometimes received harsh criticism regarding the technique, results and complications caused by the system (3)(4)(5)(6)(7)(8)(9)(10). Because of this, the French subsidiary, ISS SA (formerly IMMI) was brought into the French bankruptcy court and no further support was provided to its users.…”

An integrated CAD/CAM/robotic milling method for custom cementless femoral prostheses

“…The RoboDoc system uses a robot to mill the femoral cavity; therefore, surgical THA operations utilizing the RoboDoc system should result in good fits and fills of the femoral prosthesis within the femoral cavity [13][14][15]. Rather than milling the femoral cavity, our method uses a robot to mill the femoral prosthesis to obtain a good fit and fill of the femoral prosthesis within the femur cavity.…”

Status of robotic assistance—a less traumatic and more accurate minimally invasive surgery?

“…The system vanished from the market after many patients showed early slackening of their prostheses and some were even handicapped through muscle damage during the procedure. A major problem was the lack of sufficient studies prior to general application [14]. The device was also heavily criticized by the press, particularly in Germany, as being responsible for causing postoperative pain in patients who underwent robot-assisted hip replacement.…”