Robotic-assisted complex primary total hip arthroplasty with customized metal acetabular augment - a technical case...

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Robotic Surgery

Background:

• Severe acetabular bone loss presents a significant challenge in complex primary total hip arthroplasty (THA).
• Dysplasia and post-traumatic defects complicate acetabular reconstruction.
• Paprosky type IIIB defects require advanced reconstructive strategies.

Purpose of the Study:

• To describe a novel technique for reconstructing Paprosky type IIIB acetabular defects.
• To evaluate the integration of a custom 3D-printed titanium augment with robotic assistance in primary THA.
• To assess the feasibility and early outcomes of this combined approach.

Main Methods:

• A patient-specific, 3D-printed titanium augment was designed and utilized.
• Open-platform robotic assistance guided accurate reaming and component placement.
• CT imaging and 3D modeling were employed for preoperative planning.
• The augment was secured with screws, and a cementless cup was placed under robotic guidance.

Main Results:

• The technique successfully reconstructed a severe acetabular defect in a patient with dysplasia.
• Robotic guidance facilitated optimal component orientation and restoration of the hip center of rotation.
• The construct achieved primary stability without intraoperative complications.
• Postoperative imaging confirmed well-fixed components and anatomical restoration.

Conclusions:

• Combining patient-specific implants with robotic assistance is feasible for complex primary THA.
• This approach offers potential for enhanced precision and stable reconstruction of substantial acetabular defects.
• Further long-term studies in larger cohorts are needed to validate broader applicability and durability.