Improved accuracy of a novel fluoroscopy-based robotically assisted THA system compared to manual THA

Area of Science:

• Orthopedic Surgery
• Robotics in Medicine
• Medical Imaging

Background:

• Accurate acetabular cup placement is crucial for successful total hip arthroplasty (THA) outcomes.
• Current robotic-assisted THA (RA-THA) systems often rely on pre-operative CT scans.
• Manual THA (mTHA) techniques face challenges in achieving consistent acetabular component positioning.

Purpose of the Study:

• To evaluate the accuracy of a new fluoroscopy-based, pin-less robotic-assisted THA (RA-THA) system.
• To compare the acetabular cup placement accuracy of this novel RA-THA system against an unassisted manual THA (mTHA) approach.
• To assess the impact of the robotic system on operative and total room time.

Main Methods:

• Retrospective cohort analysis of 198 patients undergoing mTHA or RA-THA between March 2021 and July 2022.
• Primary outcome: accuracy of acetabular component placement (inclination and anteversion).
• Secondary outcomes: proportion of cups within the Lewinnek safe zone, operative time, and total operating room time.

Main Results:

• The RA-THA group showed significantly higher accuracy in acetabular anteversion compared to the mTHA group (18.5 vs. 21.7 degrees; p < 0.001).
• A significantly greater proportion of acetabular cups were placed within the Lewinnek safe zone in the RA-THA cohort (81.6% vs. 59.0%; p < 0.001).
• Operative time was longer for RA-THA (39.0 vs. 35.3 min; p = 0.003), but total operating room time remained unchanged (101.2 vs. 101.2 min; p = 0.982).

Conclusions:

• The novel fluoroscopy-based, pin-less robotic platform significantly enhances acetabular cup accuracy in THA.
• This robotic system provides a 22.6% improvement in achieving optimal cup placement within the Lewinnek safe zone compared to manual methods.
• The use of this RA-THA system improves surgical precision without increasing the overall time spent in the operating room.