The introduction of MakoPlasty Robotic Assisted Partial Knee Replacement Surgery at Burnside Hospital has been a great success. The Hospital, together with the specialists from AOTS–OrthoRobotics, are excited to be able offer the same innovative technology to patients undergoing total hip replacement surgery.
AOTS-OrthoRobotics surgeons, Dr Robert Baird, Dr Robert Fassina and Dr Justin Munt, have told us they have been able to produce precise results in hip surgery, just as they have been able to achieve with Robotic Assisted Partial Knee Replacement Surgery.
According to Dr Baird, “The pre-operative planning begins with a CT scan of the pelvis and diseased hip. This is used to create a 3D model, which then allows for a patient specific pre-operative plan to be created. The plan enables us to reliably predict the size, orientation and center of rotation of the acetabular cup and femoral stem. In effect allowing us to perform virtual surgery before the patient even enters the operating room.”
Intra-operatively, the robotic software provides real time information to allow for accurate implant positioning. The robotic arm initially guides the femoral neck resection and orientation (or version) of the femoral stem. The robotic arm then assists with acetabular reaming and cup implantation. The system provides intraoperative confirmation of component version, real leg length and combined offset,” he added.
The surgeon controlled robotic arm is designed to provide tactile (haptic) feedback, 3D visualization and auditory guidance to facilitate minimal bone removal while optimising fixation of the components. Once all components have been implanted, a summary screen allows the surgeon to confirm the results are accurate and as planned.
Dr Fassina explained that total hip replacement surgery is already associated with excellent clinical outcomes and high patient satisfaction scores. “Sometimes, however, complications such as leg length discrepancy, pain from impingement of the prosthesis or dislocation of the joint can occur. The MakoPlasty Total Hip Replacement application helps us minimise the possibility of such complications,” he said.
“The use of the robotic arm allows for the acetabular component to be reliably implanted with within 2mm and 5 degrees of the patient specific pre operative plan. It also allows for accurate leg length restoration to within 3mm,” he added.
Dr Munt said, “Studies that have been performed in the United States have shown that robotic total hip replacement aids in a patient’s rapid return of function. Compared with traditional manual procedures, these studies have demonstrated reduced impingement, wear and dislocation as well as accurate leg length restoration. All of these are known to improve patient outcome and satisfaction.”(3,6,7)
A further major benefit, according to our surgeons, is that the procedure utilizes current Stryker prostheses, which have been demonstrated to have excellent outcomes in both the Australian and International Joint Replacement Registries.(14)
Additionally, the procedure can be performed through either muscle sparing direct anterior, posterior or lateral approaches to the hip.
Burnside Hospital is pleased to be one of only a few hospital in Australia, and the only in South Australia, to offer patients the benefit of the Stryker Makoplasty Robotic Arm Assisted Total Hip Replacement. We encourage those interested in the procedure to contact one of our surgeons at AOTS-OrthoRobotics to determine their suitability for the surgery.
1 Leg-Length Discrepancy After Total Hip Arthroplasty: Comparison of Robot-Assisted Posterior, Fluoroscopy-Guided Anterior, and Conventional Posterior Approaches. El Bitar YF, Stone JC, Jackson TJ, Lindner D, Stake CE, Domb BG. AM J Orthop (Belle Mead NJ). 2015 Jun; 44(6): 265-9.
2 Does Robotic-Assisted Computer Navigation Affect Acetabular Cup Positioning in Total Hip Arthroplasty in the Obese Patient? A Comparison Study. Gupta A, Redmond JM, Hammarstedt JE, Petrakos AE, Vemula SP, Domb BG. J Arthroplasty. 2015 Dec; 30(12): 2204-7
3 Accuracy of Component Positioning in 1980 Total Hip Arthroplasties: A Comparative Analysis by Surgical Technique and Mode of Guidance. Domb BG, Redmond JM, Louis SS, Alden KJ, Daley RJ, LaReau JM, Petrakos AE, Gui C, Suarez-Ahedo C. J Arthroplasty. 2015 Dec; 30(12): 2208-18.
4 Predictive value of robotic-assisted total hip arthroplasty. El Bitar YF, Jackson TJ, Lindner D, Botser IB, Stake CE, Domb BG. Orthopedics. 2015 Jan; 38(1):e31-7.
5 The learning curve associated with robotic-assisted total hip arthroplasty. Redmond JM, Gupta A, Hammarstedt JE, Petrakos AE, Finch NA, Domb BG. J Arthroplasty. 2015 Jan; 30(1): 50-4.
6 Precision of robotic guided instrumentation for acetabular component positioning. Kanawade V, Dorr LD, Banks SA, Zhang Z, Wan Z. J Arthroplasty. 2015 Mar; 30(3): 392-7.
7 Precision of acetabular cup placement in robotic integrated total hip arthroplasty. Elson L, Dounchis J, Illgen R, Marchand RC, Padgett DE, Bragdon CR, Malchau H. Hip Int. 2015 Nov 25; 25(6): 531-6.
8 Robot-assisted total hip arthroplasty. Banerjee S, Cherian JJ, Elmallah RK, Pierce TP, Jauregui JJ, Mont MA. Expert Rev Med Devices. 2015 Dec 21: 1-10.
9 Robotic-Arm Assisted Surgery in Total Hip Arthroplasty. Elmallah RK, Cherian JJ, Jauregui JJ, Padden DA, Harwin
SF, Mont MA. Surg Technol Int. 2015 May; 26:283-8.
10 Comparison of Robotic-Assisted Posterior Approach and Fluoroscopic-Guided Anterior Approach Acetabular Cup Placement in THA. Kamara E, Robinson J, Hepinstall M, Rodriguez J. Bone Joint J. Jan 2016, 98-B (SUPP 2) 86.
11 Does haptic robot-assisted total hip arthroplasty better restore native acetabular and femoral anatomy? Tsai TY, Dimitriou D, Li JS, Kwon YM. Int J Med Robot. 2015, April 23.
12 The Learning Curve Associated with Robotic-Assisted Total Hip Arthroplasty. Domb B, Redmond J, Hammarstedt J, Petrakos A, Stake C, Gupta A, Conditt MA. Bone Joint J. Jan 2016, 98-B (SUPP 1) 95.
13 Correlation Between CT-Based Intra-Operative Radiographs for Robotic-Assisted Total Hip Arthroplasty. Domb B, Redmond J, Gupta A, Hammarstedt J, Petrakos A, Stake C, Conditt MA. Bone Joint J. Jan 2016, 98-B (SUPP 1) 96.