The Evolution of Computer-Assisted Total Hip Arthroplasty and Relevant Applications

Area of Science:

• Orthopaedic Surgery
• Medical Technology
• Robotics in Medicine

Background:

• Accurate implant positioning is critical for successful total hip arthroplasty (THA).
• Computer-assisted orthopaedic surgery (CAOS) systems aim to improve implant placement precision.
• CAOS encompasses passive navigation (imageless, CT-based, fluoroscopy-based) and active/semi-active robot-assisted systems.

Discussion:

• Imageless navigation offers novel registration methods, bypassing anterior pelvic plane requirements.
• CT-based navigation facilitates pelvic plane referencing and functional pelvic plane adjustments for cup orientation.
• Robot-assisted systems range from active (preoperative programming for femoral preparation, now cup positioning) to semi-active (initially cup positioning, now cup and stem).

Key Insights:

• Advancements in CAOS for THA include diverse navigation techniques and robotic functionalities.
• Registration innovations in imageless navigation and functional pelvic plane use in CT-based navigation enhance precision.
• Robot-assisted systems are evolving from single-component to multi-component positioning capabilities.

Outlook:

• Despite current controversies (learning curve, cost, technical issues), CAOS is poised to significantly improve THA accuracy.
• Continued rapid technological evolution in CAOS is expected to lead to better clinical outcomes in total hip arthroplasty.
• The integration of advanced navigation and robotic technologies will likely become standard in orthopaedic surgery.