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. 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).Background
Methods
Lewinnek et al described a safe zone of acetabular component placement in Total Hip Arthroplasty (THA) to reduce complications. Callanan Between June 2008 and April 2014, 2330 THRs were performed by six different surgeons. Post-operative radiographic images were retrospectively reviewed and measured using TraumaCad® software to determine cup placement, LLD, and GOD.Introduction
Methods
Pre-operative and postoperative analgesia in total hip arthroplasty (THA) involves multimodal analgesia using differing classes of drugs and varying introductions of these agents. Postoperative opioid-related events can slow recovery and increase patients' length of stay. Long-acting local anesthetics can reduce early postoperative pain at the surgical site, potentiating a decrease of opioid intervention needed postoperatively. Decreasing opioid use while maintaining adequate pain control could reduce opioid-related events, increase patient time to first ambulation and decrease length of stay. The purpose of this study was to compare liposomal bupivacaine to bupivacaine for postoperative analgesia. Between November 2012 and February 2013, 57 consecutive patients that underwent THA and hip resurfacing received either an intraoperative injection of liposomal bupivacaine or bupivacaine alone. All patients received a combination of medications prior to the procedure including celecoxib 400 mg by mouth, pregabalin 75 mg by mouth and 1gm of intravenous acetaminophen. The study group received 20 cc of liposomal bupivacaine, combined with 40 cc 0.25% bupivacaine with epinephrine and 20 cc of normal saline. The control group received 60 ml of 0.25% bupivacaine with epinephrine. Data was prospectively collected including average visual analog pain scale (VAS), opioid consumption, time to first ambulation, hospital length of stay measured by days, and post-operative opioid-related adverse drug events.Background
Methods
Component positioning in total hip arthroplasty (THA) is critical to achieve optimal patient outcomes. Recent literature has shown acetabular component positioning may be inaccurate using traditional techniques. Robotic-assisted THA is a recent platform introduced to decrease the risk of malpositioned components. However, to date, a paucity of data is available comparing the intra-operative component position generated by the navigation system to post-operative radiographs. The purpose of this study was to compare the component position measurements of a navigation system, used during robotic-assisted THA, to component position measurements obtained on post-operative radiographs.Background
Purpose
Several recent reports have documented high frequency of malpositioned acetabular components, even amongst high volume arthroplasty surgeons. Robotic assisted total hip arthroplasty (THA) has the potential to improve component positioning; however, to our knowledge there are no reports examining the learning curve during the adoption of robotic assisted THA. The purpose of this study was to examine the learning curve of robotic assisted THA as measured by component position, operative time, intra-operative technical problems, and complications.Background
Purpose
