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. 2020 May 4:16:357-368.
doi: 10.2147/TCRM.S246565. eCollection 2020.

Robot-Assisted Total Hip Arthroplasty for Arthrodesed Hips

Wei Chai  1 , Xiangpeng Kong  1 , Minzhi Yang  1   2 , Ken Lee Puah  3 , Peifu Tang  1 , Jiying Chen  1
Affiliations

Robot-Assisted Total Hip Arthroplasty for Arthrodesed Hips

Wei Chai et al. Ther Clin Risk Manag. .

Erratum in

Abstract

Background: Conversion of arthrodesed hips to total hip arthroplasty (THA) remains technically demanding. This study aims to evaluate the safety and efficacy of robot-assisted THA in arthrodesed hips.

Methods: We retrospectively analyzed 45 ankylosing spondylitis patients with hip arthrodesis in the Chinese PLA General Hospital between August 2018 and August 2019. All surgeries were carried out by one single surgeon. The patients were followed at 3 months after surgery. Gender, body mass index, angle of hip arthrodesis, operating time, intraoperative fluoroscopic times, postoperative length of hospitalization, cup positioning, postoperative leg length discrepancy, offset discrepancy, intraoperative and postoperative complications, and postoperative Harris Hip Score were collected for all patients.

Results: Twenty-two patients (35 hips) who underwent robot-assisted THA and 23 patients (37 hips) who underwent manual THA were enrolled in this study. There were no significant differences in demographics and arthrodesed angles between the two groups. The fluoroscopic times during manual THA were significantly higher than those during robot-assisted THA (2.16±1.61 vs 0.47±0.61, respectively, p=0.000). In the robotic group, the percentage of acetabular cups within the safe zone was significantly greater than in the manual group (94.29% vs 67.56%, respectively, p=0.042). For manual THA, the anteversions were significantly different between the left and right sides (21.14±7.86 vs 16.00±6.32, respectively, p=0.042); however, no such significant difference was found in robot-assisted THA.

Conclusion: Compared with manual THA for arthrodesed hips, robot-assisted THA had significant advantages in improving the frequency of achieving cup positioning within the target zone with diminished radiation dose and no increase in operating time.

Keywords: cup positioning; hip arthrodesis; robot-assisted surgery; total hip arthroplasty.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Preoperative X-rays and three-dimensional model construction of the arthrodesed hip. (A) Preoperative anteroposterior X-rays of bilateral hips. (B) Three-dimensional model construction of pelvis in the robotic system.
Figure 2
Figure 2
Preoperative surgical plan of positioning of components in the robotic system.
Figure 3
Figure 3
Preoperative surgical plan of positioning of pelvic landmarks in the robotic system. (A) Anterior superior iliac spine (blue point). (B) Posterior acetabulum (blue point). (C) Anterior acetabulum (blue point). (D) Superior acetabulum (blue point). (E) Rotation center (blue point) (the above pelvic landmarks are usually shown as green and change to blue when being captured).
Figure 4
Figure 4
Accuracy of intraoperative pelvic registration (green points: <0.5 mm; yellow points: 0.5–1.5 mm; red points: >1.5 mm).
Figure 5
Figure 5
Verification of intraoperative pelvic registration (blue points changed to white and distance to bone was <1 mm).
Figure 6
Figure 6
Intraoperative image of acetabulum reaming (the white acetabulum is the planned volume of bone being removed).
Figure 7
Figure 7
Comparison of preoperative surgical plan and postoperative X-rays of the arthrodesed hip. (A) Robotic surgical plan. (B) Actual postoperative X-rays.
Figure 8
Figure 8
Box-plot of inclination and anteversion in robot-assisted THA and manual THA (○ means abnormal value and * means outlier).
See this image and copyright information in PMC

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