Robotic arm-assisted versus manual total hip arthroplasty

2021 ◽  
Vol 103-B (6) ◽  
pp. 1009-1020 ◽  
Author(s):  
Nathan Ng ◽  
Paul Gaston ◽  
Philip M. Simpson ◽  
Gavin J. Macpherson ◽  
James T. Patton ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Hip Arthroplasty ◽  
Learning Curve ◽  
Hip Arthroplasty ◽  
Functional Outcomes ◽  
Meta Analysis ◽  
Robotic Arm ◽  
Complication Rates ◽  
Total Hip

Aims The aims of this systematic review were to assess the learning curve of semi-active robotic arm-assisted total hip arthroplasty (rTHA), and to compare the accuracy, patient-reported functional outcomes, complications, and survivorship between rTHA and manual total hip arthroplasty (mTHA). Methods Searches of PubMed, Medline, and Google Scholar were performed in April 2020 in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. Search terms included “robotic”, “hip”, and “arthroplasty”. The criteria for inclusion were published clinical research articles reporting the learning curve for rTHA (robotic arm-assisted only) and those comparing the implantation accuracy, functional outcomes, survivorship, or complications with mTHA. Results There were 501 articles initially identified from databases and references. Following full text screening, 17 articles that satisfied the inclusion criteria were included. Four studies reported the learning curve of rTHA, 13 studies reported on implant positioning, five on functional outcomes, ten on complications, and four on survivorship. The meta-analysis showed a significantly greater number of cases of acetabular component placement in the safe zone compared with the mTHA group (95% confidence interval (CI) 4.10 to 7.94; p < 0.001) and that rTHA resulted in a significantly better Harris Hip Score compared to mTHA in the short- to mid-term follow-up (95% CI 0.46 to 5.64; p = 0.020). However, there was no difference in infection rates, dislocation rates, overall complication rates, and survival rates at short-term follow-up. Conclusion The learning curve of rTHA was between 12 and 35 cases, which was dependent on the assessment goal, such as operating time, accuracy, and team working. Robotic arm-assisted total hip arthroplasty was associated with improved accuracy of component positioning and functional outcome, however no difference in complication rates or survival were observed at short- to mid-term follow-up. Overall, there remains an absence of high-quality level I evidence and cost analysis comparing rTHA and mTHA. Cite this article: Bone Joint J 2021;103-B(6):1009–1020.

Adoption of Robotic Arm-Assisted Total Hip Arthroplasty Results in Reliable Clinical and Radiographic Outcomes at Minimum Two-Year Follow Up

2021 ◽  
Author(s):  
Matthew Hepinstall ◽  
Harrison Zucker ◽  
Chelsea Matzko ◽  
Morteza Meftah ◽  
Michael Mont
Keyword(s):  
Total Hip Arthroplasty ◽  
Clinical Outcomes ◽  
Hip Arthroplasty ◽  
Case Series ◽  
Robotic Arm ◽  
Complication Rates ◽  
Total Hip ◽  
Surgical Assistance ◽  
Published Evidence

Introduction: Longevity and success of total hip arthroplasty (THA) is largely dependent on component positioning. While use of robotic platforms can improve this positioning, published evidence on its clinical benefits is limited. Therefore, the aim of this study was to assess the clinical outcomes of THA with robotic surgical assistance. Materials and Methods: We conducted an analysis of robotic arm-assisted primary THAs performed by a single surgeon utilizing a posterior approach. A total of 99 patients (107 cases) who had a minimum two-year follow up were identified. Their mean age was 61 years (range, 33 to 84 years), and their mean body mass index was 30.5 kg/m2 (range, 18.5 to 49.1 kg/m2). There were 56% female patients and primary osteoarthritis was the principal hip diagnosis in 88.8%. Operative times, lengths of hospital stay, and discharge dispositions were recorded, along with any complications. Modified Harris Hip Scores (HHS) were calculated to quantify clinical outcomes. Results: Mean postoperative increases in HHS at 2- to 5.7-year follow up was 33 points (range, 6 to 77 points). There were no complications attributable to the use of robotic assistance. Surgical-site complications were rare; one case underwent a revision for prosthetic joint infection (0.93%) but there were no dislocations, periprosthetic fractures, or cases of mechanical implant loosening. There was no evidence of progressive radiolucencies or radiographic failure. Discussion: Robotic arm-assisted THA resulted in low complication rates at minimum two-year follow up, with clinical outcomes comparable to those reported with manual surgery.1–4 The haptically-guided acetabular bone preparation enabled reliable cementless acetabular fixation and there were no adverse events related to the use of the robot. Dislocations were avoided in this case series. Randomized controlled clinical trials are needed to compare manual to robotic surgery and to investigate whether the precision found with this functional planning will reliably reduce the incidence of dislocations.

Functional Outcomes of Total Hip Arthroplasty in Patients Aged 30 Years or Less: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 26 (5) ◽  
pp. 424-431 ◽  
Author(s):  
Roland P. Walker ◽  
Matthew Gee ◽  
Fabian Wong ◽  
Zameer Shah ◽  
Marc George ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Functional Outcomes ◽  
Meta Analysis ◽  
Total Hip

scholarly journals Increased Mortality in Metal-on-Metal versus Non-Metal-on-Metal Primary Total Hip Arthroplasty at 10 Years and Longer Follow-Up: A Systematic Review and Meta-Analysis

PLoS ONE ◽  
2016 ◽  
Vol 11 (6) ◽  
pp. e0156051 ◽  
Author(s):  
B. G. Pijls ◽  
J. M. T. A. Meessen ◽  
J. W. Schoones ◽  
M. Fiocco ◽  
H. J. L. van der Heide ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Meta Analysis ◽  
Total Hip ◽  
Metal On Metal ◽  
Primary Total Hip Arthroplasty

scholarly journals Does Surgical Approach Affect Outcomes in Total Hip Arthroplasty Through 90 Days of Follow-Up? A Systematic Review With Meta-Analysis

2018 ◽  
Vol 33 (4) ◽  
pp. 1296-1302 ◽  
Author(s):  
Larry E. Miller ◽  
Joseph S. Gondusky ◽  
Samir Bhattacharyya ◽  
Atul F. Kamath ◽  
Friedrich Boettner ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Surgical Approach ◽  
Meta Analysis ◽  
Total Hip

scholarly journals Robotic-assisted compared with conventional total hip arthroplasty: systematic review and meta-analysis

2018 ◽  
Vol 94 (1112) ◽  
pp. 335.1-341 ◽  
Author(s):  
Xi Chen ◽  
Jianping Xiong ◽  
Peipei Wang ◽  
Shibai Zhu ◽  
Wenting Qi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Complication Rates ◽  
Safety And Efficacy ◽  
Robotic Assisted ◽  
Total Hip

BackgroundRobotic-assisted total hip arthroplasty (THA) allows for accurate preoperative planning and component positioning, potentially enhancing implant survival and long-term outcomes. The relative efficacy and safety of robotic-assisted and conventional THA, however, are unclear. This systematic review and meta-analysis compared the safety and efficacy of robotic-assisted and conventional THA.MethodsMedline, Embase and the Cochrane Library were comprehensively searched in September 2017 to identify studies comparing the safety and efficacy of robotic-assisted and conventional THA. Seven studies were included. Data of interest were extracted and analysed using Review Manager 5.3.ResultsThe seven included studies involved 1516 patients, with 522 undergoing robotic-assisted and 994 undergoing conventional THA. Compared with conventional THA, robotic-assisted THA was associated with longer surgical time (not significant); lower intraoperative complication rates (OR: 0.12, 95% CI: 0.05 to 0.34, p<0.0001 I2); better cup placement, stem placement and global offset and a higher rate of heterotopic ossifications. Functional scores, limb length discrepancy and rates of revision and stress shielding were similar in the two groups. The relative amount of blood loss was unclear.ConclusionThe results of this meta-analysis suggest that robotic-assisted THA has certain advantages over conventional THA, including the results of component positioning and rates of intraoperative complications. Additional comparative studies are required to determine the long-term clinical outcomes of robotic-assisted THA.

Efficacy of NSAIDs versus radiotherapy for heterotopic ossification prophylaxis following total hip arthroplasty in high-risk patients: a systematic review and meta-analysis

2021 ◽  
pp. 112070002199111
Author(s):  
Jacob Shapira ◽  
Mitchell J Yelton ◽  
Jeffery W Chen ◽  
Philip J Rosinsky ◽  
David R Maldonado ◽  
...  
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Meta Analysis ◽  
Comparable Efficacy ◽  
Total Hip ◽  
High Risk Patients ◽  
Randomised Control Trials ◽  
Risk Patients

Background: The aims of this systematic review were: (1) to investigate the prophylactic effect of radiotherapy (RT) and NSAIDs in high-risk patients following total hip arthroplasty (THA); and (2) to compare the efficacy of non-selective and COX-II selective NSAIDs in preventing post-THA HO, utilising a meta-analysis of randomised control studies. Methods: The PubMed, Embase, and Cochrane Databases were searched for articles regarding HO following THA in March 2019. Studies were included if they contained data regarding HO incidence after THA or contained data regarding HO prophylaxis comparison of NSAIDs and/or RT in terms of dosage or duration. Results: 24 studies reported on populations that were not at high-risk for HO. These studies reported between 47.3% and 90.4% of their patient populations had no HO formation; between 2.8% and 52.7% had mild formation; and between 0.0% and 10.4% had severe formation. A total of 13 studies reported on populations at high-risk for HO. Studies analysing RT in high-risk patients reported between 28.6% and 97.4% of patients developed no HO formation; between 1.9% and 66.7% developed mild HO formation; and between 0.0% and 11.9% developed severe HO formation. Studies analysing NSAID treatment among high-risk populations reported between 76.6% and 88.9% had no HO formation; between 11.1% and 23.4% had mild HO formation, and between 0.0% and 1.8% had severe HO formation. 9 studies were identified as randomised control trials and subsequently used for meta-analysis. The relative risk for COX-II in developing any HO after THA was not significantly different compared to non-selective NSAIDs (RR 1.00; CI, 0.801–1.256; p = 0.489). Conclusions: NSAIDs prophylaxis for HO may have better efficacy than RT in high-risk patients following THA. Non-selective and COX-II selective NSAIDs have comparable efficacy in preventing HO. Factors such as medical comorbidities and side-effect profile should dictate the prophylaxis recommendation.

The learning curve for the direct anterior total hip arthroplasty: a systematic review

2021 ◽  
Author(s):  
Leah Nairn ◽  
Lauren Gyemi ◽  
Kyle Gouveia ◽  
Seper Ekhtiari ◽  
Vickas Khanna
Keyword(s):  
Systematic Review ◽  
Total Hip Arthroplasty ◽  
Learning Curve ◽  
Hip Arthroplasty ◽  
Total Hip
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