Computer Assisted Orthopaedic Surgery in Total Hip Arthroplasty with Alumina Alumina Pairing

Computer assisted orthopaedic surgery (CAOS) technology has recently been introduced to overcome problems resulting from acetabular component malpositioning in total hip arthroplasty. Available navigation modules can conceptually be categorized as computer tomography (CT) based, fluoroscopy based, or image-free. The current study presents a comprehensive accuracy analysis on the computer assisted placement accuracy of acetabular cups. It combines analyses using mathematical approaches, in vitro testing environments, and an in vivo clinical trial. A hybrid navigation approach combining image-free with fluoroscopic technology was chosen as the best compromise to CT-based systems. It introduces pointer-based digitization for easily assessable points and bi-planar fluoroscopy for deep-seated landmarks. From the in vitro data maximum deviations were found to be 3.6° for inclination and 3.8° for anteversion relative to a pre-defined test position. The maximum difference between intraoperatively calculated cup inclination and anteversion with the postoperatively measured position was 4° and 5°, respectively. These data coincide with worst cases scenario predictions applying a statistical simulation model. The proper use of navigation technology can reduce variability of cup placement well within the surgical safe zone. Surgeons have to concentrate on a variety of error sources during the procedure, which may explain the reported strong learning curves for CAOS technologies.

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A review of the evolution of robotic-assisted total hip arthroplasty

Hip International ◽

10.1177/1120700019828286 ◽

2019 ◽

Vol 29 (3) ◽

pp. 232-238 ◽

Cited By ~ 7

Author(s):

Padmanabhan Subramanian ◽

Tom W Wainwright ◽

Shayan Bahadori ◽

Robert G Middleton

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Orthopaedic Surgery ◽

New Technology ◽

Hip Surgery ◽

Cochrane Library ◽

Computer Assisted ◽

Successful Operation ◽

Total Hip ◽

Pubmed Database

Introduction: Total hip arthroplasty (THA) is currently a very successful operation but continues to evolve as we try to perfect techniques and improve outcomes for our patients. Robotic hip surgery (RHS) began with the ‘active’ ROBODOC system in the 1980s. There were drawbacks associated with the original ROBODOC and most recently, the MAKO robot was introduced with early promising results. Aim: The aim of this paper is to provide an up-to-date review surrounding this area and discuss the pros and cons of this technique. Methods: A literature review searching Medline, Embase, Ovidsp, Cochrane library, pubmed database and google scholar was performed searching keywords including: ‘Robotic hip surgery’, ‘Robotic orthopaedic surgery’, ‘Computer assisted hip surgery’, ‘robotic arthroplasty’, and ‘computer assisted orthopaedic surgery’. Conclusion: Robotic hip surgery aims to tackle the limitations of the human factor in surgery by promising reproducible and reliable methods of component positioning in arthroplasty surgery. However, as orthopaedic surgeons, we must critically appraise all new technology and support the use providing there is sound robust evidence backing it.

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