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Cement Removal from the Femur Using the ROBODOC System in Revision Total Hip Arthroplasty
Mitsuyoshi Yamamura1, Nobuo Nakamura, Hidenobu Miki
1Center of Arthroplasty, Kyowakai Hospital, 1-24-1 Kishibekita, Suita, Osaka 564-0001, Japan.
Insights
The ROBODOC system safely removes bone cement during revision total hip arthroplasty (THA), preventing femur fractures. This innovative approach allows for early weight-bearing and improved patient outcomes.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Femoral perforation and fracture are significant risks during cement removal in revision total hip arthroplasty (THA).
- The ROBODOC system offers a novel approach for selective bone cement removal in the femoral canal.
Purpose of the Study:
- To evaluate the clinical and radiographic outcomes of revision THA utilizing the ROBODOC system for bone cement removal.
- To assess the safety and efficacy of the ROBODOC system in preventing femoral complications during revision THA.
Main Methods:
- A cohort of 19 patients undergoing revision THA with the ROBODOC system was studied.
- Clinical outcomes (Merle d'Aubigne and Postel score) and radiographic findings (cement removal, femoral integrity) were assessed.
- Postoperative weight-bearing status and complications were meticulously recorded over a median follow-up of 109 months.
Main Results:
- Complete removal of bone cement was achieved in all cases.
- The mean Merle d'Aubigne and Postel score improved significantly from 10 to 14 points.
- No femoral perforations or fractures occurred; early weight-bearing was facilitated by preserved femoral cortex.
Conclusions:
- The ROBODOC system provides a safe and effective method for bone cement removal in revision THA.
- Utilizing the ROBODOC system minimizes the risk of serious femoral complications.
- Preservation of the femoral cortex with ROBODOC enables accelerated patient rehabilitation and early weight-bearing.
Abstract:
Introduction. The perforation and fracture of the femur during the removal of bone cement in revision total hip arthroplasty (THA) are serious complications. The ROBODOC system has been designed to selectively remove bone cement from the femoral canal, but results have not been reported yet. The purpose of our study was to evaluate the clinical and radiographic results of revision THA using the ROBODOC system for cement removal. Materials and Methods. The subjects comprised 19 patients who underwent revision THA using the ROBODOC system. The minimum duration of follow-up was 76 months (median, 109 months; range, 76-150 months). The extent of remaining bone cement on postoperative radiography, timing of weight bearing, and the complications were evaluated. Results. The mean Merle d'Aubigne and Postel score increased from 10 points preoperatively to 14 points by final follow-up. Bone cement was completely removed in all cases. Full weight bearing was possible within 1 week after surgery in 9 of the 19 cases and within 2 months in all remaining cases. No instances of perforation or fracture of the femur were encountered. Conclusions. Bone cement could be safely removed using the ROBODOC system, and no serious complications occurred. Full weight bearing was achieved early in the postoperative course because of circumferential preservation of the femoral cortex.
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