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General Orthopaedics

Comparison of Robotic Milling and Manual Rasping for Short Stem Total Hip Arthroplasty: A Prospective Randomised Controlled Trial

International Society for Technology in Arthroplasty (ISTA)



Abstract

Introduction:

The robot-assisted cementless total hip arthroplasty has theoretical advantages of providing better fit and mechanical stability of the stem. However, no previous study has been reported on a short stem implantation using surgical robot. We compared early clinical and radiographic results between robotic milling and manual rasping in short stem total hip arthroplasty.

Materials & Methods:

We designed a prospective randomized controlled trial to determine whether robot-assisted short stem total hip arthroplasty improves the implant position represented by stem alignment, leg length equality, and reduces the intraoperative and early postoperative complications. A total of 40 patients were enrolled with informed consents and randomly assigned to robotic milling group (20 hips) and manual rasping group (20 hips) by means of a computer-generated random number table. There were no statistically significant differences in the demographics of the patients between the two groups

Results:

Total operation time of the robotic milling group was significantly longer than that of the manual rasping group (p = 0.015) with average 8.8 minutes registration time and average 11.1 minutes milling time. There was no significantly difference in total blood loss between the two groups. The robotic milling group showed superior results on stem alignment and leg length equality compared with the manual rasping group. Only in the manual rasping group, there were 2 intraoperative femoral fractures. No complications such as infection, nerve palsy or dislocation encountered in both groups.

Conclusions:

Robotic-assisted short stem total hip arthroplasty has advantages in increased accuracy of stem alignment and leg length equality, and also helps reduce the potential risk of intraoperative femoral fracture.


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