Your browser doesn't support javascript.
loading
A prospective randomized controlled trial comparing CT-based planning with conventional total hip arthroplasty versus robotic arm-assisted total hip arthroplasty.
Fontalis, Andreas; Kayani, Babar; Plastow, Ricci; Giebaly, Dia E; Tahmassebi, Jenni; Haddad, Isabella C; Chambers, Alastair; Mancino, Fabio; Konan, Sujith; Haddad, Fares S.
Afiliación
  • Fontalis A; Department of Trauma and Orthopaedic Surgery, University College London Hospitals NHS Foundation Trust, London, UK.
  • Kayani B; Division of Surgery and Interventional Science, University College London, London, UK.
  • Plastow R; Department of Trauma and Orthopaedic Surgery, University College London Hospitals NHS Foundation Trust, London, UK.
  • Giebaly DE; Department of Trauma and Orthopaedic Surgery, University College London Hospitals NHS Foundation Trust, London, UK.
  • Tahmassebi J; Department of Trauma and Orthopaedic Surgery, University College London Hospitals NHS Foundation Trust, London, UK.
  • Haddad IC; Division of Surgery and Interventional Science, University College London, London, UK.
  • Chambers A; Department of Trauma and Orthopaedic Surgery, University College London Hospitals NHS Foundation Trust, London, UK.
  • Mancino F; Department of Trauma and Orthopaedic Surgery, University College London Hospitals NHS Foundation Trust, London, UK.
  • Konan S; Department of Trauma and Orthopaedic Surgery, University College London Hospitals NHS Foundation Trust, London, UK.
  • Haddad FS; Department of Trauma and Orthopaedic Surgery, University College London Hospitals NHS Foundation Trust, London, UK.
Bone Joint J ; 106-B(4): 324-335, 2024 Apr 01.
Article en En | MEDLINE | ID: mdl-38555946
ABSTRACT

Aims:

Achieving accurate implant positioning and restoring native hip biomechanics are key surgeon-controlled technical objectives in total hip arthroplasty (THA). The primary objective of this study was to compare the reproducibility of the planned preoperative centre of hip rotation (COR) in patients undergoing robotic arm-assisted THA versus conventional THA.

Methods:

This prospective randomized controlled trial (RCT) included 60 patients with symptomatic hip osteoarthritis undergoing conventional THA (CO THA) versus robotic arm-assisted THA (RO THA). Patients in both arms underwent pre- and postoperative CT scans, and a patient-specific plan was created using the robotic software. The COR, combined offset, acetabular orientation, and leg length discrepancy were measured on the pre- and postoperative CT scanogram at six weeks following surgery.

Results:

There were no significant differences for any of the baseline characteristics including spinopelvic mobility. The absolute error for achieving the planned horizontal COR was median 1.4 mm (interquartile range (IQR) 0.87 to 3.42) in RO THA versus 4.3 mm (IQR 3 to 6.8; p < 0.001); vertical COR mean 0.91 mm (SD 0.73) in RO THA versus 2.3 mm (SD 1.3; p < 0.001); and combined offset median 2 mm (IQR 0.97 to 5.45) in RO THA versus 3.9 mm (IQR 2 to 7.9; p = 0.019). Improved accuracy was observed with RO THA in achieving the desired acetabular component positioning (root mean square error for anteversion and inclination was 2.6 and 1.3 vs 8.9 and 5.3, repectively) and leg length (mean 0.6 mm vs 1.4 mm; p < 0.001). Patient-reported outcome measures were comparable between the two groups at baseline and one year. Participants in the RO THA group needed fewer physiotherapy sessions postoperatively (median six (IQR 4.5 to 8) vs eight (IQR 6 to 11; p = 0.005).

Conclusion:

This RCT suggested that robotic-arm assistance in THA was associated with improved accuracy in restoring the native COR, better preservation of the combined offset, leg length correction, and superior accuracy in achieving the desired acetabular component positioning. Further evaluation through long-term and registry data is necessary to assess whether these findings translate into improved implant survival and functional outcomes.
Asunto(s)
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroplastia de Reemplazo de Cadera / Procedimientos Quirúrgicos Robotizados / Prótesis de Cadera Límite: Humans Idioma: En Revista: Bone Joint J Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroplastia de Reemplazo de Cadera / Procedimientos Quirúrgicos Robotizados / Prótesis de Cadera Límite: Humans Idioma: En Revista: Bone Joint J Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Reino Unido