Abstract
Background
Robotics assisted surgery are tools that provide successful biomechanical reconstruction of the hip. We compare the accuracy of cup placement in the safe zones described by Lewinnek et al. and Callanan et al., leg length discrepancy (LLD) and global offset (GO) measurement in total hip arthroplasty (THA) using five diferent image guided techniques performed by six diferent surgeons.
Methods
Between June 2008 and April 2014, 2330 THRs were performed by six different surgeons. Ninety-three (4.69%) patients underwent robotic-assisted THA anterior approach, 135 (6.8%) had robotic-assisted THA posterior approach, 942 (47.5%) patients underwent fluoroscopic guided THA anterior approach, 708 (35.7%) had THA without guidance using posterior approach, 43 (2.1%) patients underwent navigation-guided anterior approach and 59 (2.9%) patients underwent radiographic-guided posterior approach THAs (Figure 1).
Results
One Thousand, nine hundred-eigthy patients met the inclusion and exclusion criteria. Robotic guidance groups had a significantly greater percentage of hips in the Lewinnek's and Callanan's safe zone (p < 0.005). Between robotic guidance groups, the group with posterior approach has more cups placed in the Lewinnek's and Callanan's safe zone (p < 0.005). The frequency of hips within the Lewinnek's safe zone was significantly greater in the navigation guided group, compared to the other groups except robotic guided (p < 0.05) (Figure 2). Sixty-four (3.2%) of our cases were with LLD greater than or equal to 10mm, five of those cases were (8.5%) in the group treated with x-ray guidance (p < 0.05) (Figure 3). The mean GOD for the overall cohort was 4.0mm ± 0.4mm (p < 0.0001) (Figure 3). Mean ages of patients in the treatment groups were significantly different (p < 0.0001).
Conclusion
Robotic assisted surgery was more consistent than the other techniques in placing the acetabular cup into the Lewinnek and Callanan safe zone. In general, we can conclude that the useof the robot in hip arthroplasty surgery is more accurate fulfilling the goals needed to actual hip arthroplasty. We know new technologies will be developed.
