Top

Clinical Orthopaedics and Related Research®

Published in:

01-04-2010 | Clinical Research

A Comparison between Robotic-assisted and Manual Implantation of Cementless Total Hip Arthroplasty

Authors: Nobuo Nakamura, MD, Nobuhiko Sugano, MD, Takashi Nishii, MD, Akihiro Kakimoto, MD, Hidenobu Miki, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 4/2010

Abstract

Background

The benefits of robotic techniques for implanting femoral components during THA are still controversial.

Questions/Purposes

The purpose of this study was to prospectively compare the results and complications of robotic-assisted and hand-rasping stem implantation techniques.

Method

The minimum followup was 5 years (mean, 67 months; range, 60–85 months). One hundred forty-six primary THAs on 130 patients were included in this study. Robot-assisted primary THA was performed on 75 hips and a hand-rasping technique was used on 71 hips.

Results

At 2 and 3 years postoperatively, the Japanese Orthopaedic Association (JOA) clinical score was slightly better in the robotic-assisted group. At 5 years followup, however, the differences were not significant. Postoperative limb lengths of the robotic-milling group had significantly less variance than the hand-rasping group. At 2 years postoperatively, there was significantly more stress shielding of the proximal femur in the hand-rasping group; this difference was more significant 5 years postoperatively.

Conclusions

Substantially more precise implant positioning seems to have led to less variance in limb-length inequality and less stress shielding of the proximal femur 5 years postoperatively.

Level of Evidence

Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Akhavan S, Goldberg VM. Clinical outcome of a fibermetal taper stem: minimum 5-year followup. Clin Orthop Relat Res. 2007;465:106–111.PubMed

Aoki S. BlackBox—data analysis on the WWW. Available at: http://aoki2.si.gunma-u.ac.jp/BlackBox/BlackBox.html. Accessed July 11, 2009.

Bargar WL, Bauer A, Börner M. Primary and revision total hip replacement using the Robodoc system. Clin Orthop Relat Res. 1998;354:82–91.CrossRefPubMed

Brooker AF, Bowerman JW, Robinson RA, Riley LH Jr. Ectopic ossification following total hip replacement: incidence and a method of classification. J Bone Joint Surg Am. 1973;55:1629–1632.PubMed

Cohen J. A power primer. Psychol Bull. 1992;112:155–159.CrossRefPubMed

Crowe JF, Mani VJ, Ranawat CS. Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am. 1979;61:15–23.PubMed

DiGioia AM 3rd, Jaramaz B, Colgan BD. Computer assisted orthopaedic surgery: image guided and robotic assistive technologies. Clin Orthop Relat Res. 1998;354:8–16.CrossRefPubMed

Dorr LD. Optimizing results of total joint arthroplasty. Instr Course Lect. 1985;34:401–404.PubMed

Engh CA, Bobyn JD, Glassman AH. Porous-coated hip replacement: the factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg Br. 1987;69:45–55.PubMed

10.

Engh CA, Glassman AH, Suthers KE. The case for porous-coated hip implants: the femoral side. Clin Orthop Relat Res. 1990;261:63–81.PubMed

11.

Glas PY, Béjui-Hugues J, Carret JP. [Total hip arthroplasty after treatment of acetabular fracture] [in French]. Rev Chir Orthop Reparatrice Appar Mot. 2005;91:124–131.PubMed

12.

Hagio K, Sugano N, Takashina M, Nishii T, Yoshikawa H, Ochi T. Effectiveness of the ROBODOC system in preventing intraoperative pulmonary embolism. Acta Orthop Scand. 2003;74:264–269.CrossRefPubMed

13.

Hananouchi T, Sugano N, Nishii T, Nakamura N, Miki H, Kakimoto A, Yamamura M, Yoshikawa H. Effect of robotic milling on periprosthetic bone remodeling. J Orthop Res. 2007;25:1062–1069.CrossRefPubMed

14.

Harwin SF. Trochanteric heterotopic ossification after total hip arthroplasty performed using a direct lateral approach. J Arthroplasty. 2005;20:467–472.CrossRefPubMed

15.

Honl M, Dierk O, Gauck C, Carrero V, Lampe F, Dries S, Quante M, Schwieger K, Hille E, Morlock MM. Comparison of robotic-assisted and manual implantation of a primary total hip replacement: a prospective study. J Bone Joint Surg Am. 2003;85:1470–1478.PubMed

16.

Nakamura T, Mitsuishi K, Kabata T, Sakagoshi D. Fit of VerSys cementless taper stem in total hip arthroplasty. Hip Joint. 2006;32:477–479.

17.

Nishihara S, Sugano N, Nishii T, Miki H, Nakamura N, Yoshikawa H. Comparison between hand rasping and robotic milling for stem implantation in cementless total hip arthroplasty. J Arthroplasty. 2006;21:957–966.CrossRefPubMed

18.

Nishihara S, Sugano N, Nishii T, Tanaka H, Yoshikawa H, Ochi A. Comparison of the fit and fill between the Anatomic Hip femoral component and the VerSys Taper femoral component using virtual implantation on the ORTHODOC workstation. J Orthop Sci. 2003;8:352–360.CrossRefPubMed

19.

Nogler M, Maurer H, Wimmer C, Gegenhuber C, Bach C, Krismer M. Knee pain caused by a fiducial marker in the medial femoral condyle: a clinical and anatomic study of 20 cases. Acta Orthop Scand. 2001;72:477–480.PubMedCrossRef

20.

Paul HA, Bargar WL, Mittlestadt B, Musits B, Taylor RH, Kazanzides P, Zuhars J, Williamson B, Hanson W. Development of a surgical robot for cementless total hip arthroplasty. Clin Orthop Relat Res. 1992;285:57–66.PubMed

21.

ROBODOC, a CUREXO Technology Corporation. Available at: http://www.robodoc.com. Accessed July 11, 2009.

22.

Schulz AP, Seide K, Queitsch C, von Haugwitz A, Meiners J, Kienast B, Tarabolsi M, Kammal M, Jürgens C. Results of total hip replacement using the Robodoc surgical assistant system: clinical outcome and evaluation of complications for 97 procedures. Int J Med Robot. 2007;3:301–306.PubMed

23.

Shima Y. [Present status of surgical treatment of arthrosis deformans of the hip and summary of therapeutic evaluation] [in Japanese]. Nippon Seikeigeka Gakkai Zasshi. 1971;45:828–831.PubMed

24.

Williamson JA, Reckling FWJ. Limb length discrepancy and related problems following total hip joint replacement. Clin Orthop Relat Res. 1978;134:135–138.PubMed

25.

Yamauchi Y, Jinno T, Asoh Y, Koga D, Morita S, Muneda D, Shinomiya K. Short-term comparison between ZIMMER VerSys Taper stem and Midcoat stem in bilateral total hip arthroplasty. Hip Joint. 2006;32:469–472.

Title: A Comparison between Robotic-assisted and Manual Implantation of Cementless Total Hip Arthroplasty
Authors: Nobuo Nakamura, MD
Nobuhiko Sugano, MD
Takashi Nishii, MD
Akihiro Kakimoto, MD
Hidenobu Miki, MD
Publication date: 01-04-2010
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 4/2010
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-009-1158-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A Comparison between Robotic-assisted and Manual Implantation of Cementless Total Hip Arthroplasty

Abstract

Background

Questions/Purposes

Method

Results

Conclusions

Level of Evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Questions/Purposes

Method

Results

Conclusions

Level of Evidence

Please log in to get access to this content

Other articles of this Issue 4/2010

The Classic: On the Theory of Fracture Healing

Case Report: Psoriatic Erythroderma with Bilateral Osseous Bridge Across the Acetabulum

High Union Rates and Function Scores at Midterm Followup With Ankle Arthrodesis Using a Four Screw Technique

Radiofrequency Energy on Cortical Bone and Soft Tissue: A Pilot Study

Fine Needle Aspiration for Clinical Triage of Extremity Soft Tissue Masses

Compartment Syndrome of the Lower Leg and Foot