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Robotic Total Hip Arthroplasty

Total hip arthroplasty offers several key benefits over conventional manual procedures.

For patients who suffer from non-inflammatory or inflammatory degenerative joint disease of the hip who no longer respond to non-surgical treatment options, total hip arthroplasty (THA) is often recommended. Yet, despite its safety and long-term outcomes, 90% of total hip arthroplasty patients decline surgery.1

Conventional total hip arthroplasty relies on instrumentation and alignment guides or visual assessment for bone preparation and implant alignment. Poorly placed or misaligned implants can lead to impingement, wear, and dislocation.2

The use of highly advanced, surgeon-controlled robotic arm technology eliminates much of the guesswork of manual total hip arthroplasty, consistently and reproducibly resulting in increased accuracy. This maximizes the opportunity for improved surgical results and patient satisfaction, and may increase the lifespan of the hip implant.

About the Procedure

Surgeons on the medical staff at Baylor Scott & White Health are enabled to plan and perform the procedure with consistently reproducible precision.

  • Patient-specific pre-operative planning –Using the patient’s CT scan, a 3-D model is created to specifically plan the procedure for each patient’s unique anatomy, considering implant size, orientation, and the center of rotation for the acetabular cup and hip stem.
  • Real-time intra-operative adjustments –Real-time data enables surgeons to fine-tune implant positioning and placement to optimize results.
  • Surgeon-controlled robotic arm –The robotic arm provides 3-D visualization, auditory, and tactile feedback, to ensure accurate bone preparation and implant placement.

Robotic Arthroplasty Benefits

Total hip arthroplasty offers the following key benefits over conventional manual procedures:

  • More accurate cup placement –Robotic surgery enables acetabular cup inclination and version accuracy within ±5° of plan and center of rotation within ±2mm of the plan.3 This reduces potential for impingement, wear and dislocation.2 Impingement is the No. 1 cause of failure in total hip arthroplasty.4
  • More accurate leg length restoration –Use of the robot enables leg length restoration accuracy within ±3mm of plan,3 reducing potential for discomfort and walking complications for your patients.5

Clinical Studies

Recent clinical studies have demonstrated that robotic arm assisted arthroplasty can improve accuracy in hip implant placement, minimizing potential for short-term and long-term adverse outcomes.

Key results include:

  • Four to six times more accurate cup placement than that of conventional total hip arthroplasty.6 Accurate implant placement can reduce potential for hip implant wear, loosening, and dislocation.2
  • Significantly lower dislocation rates than conventional total hip arthroplasty (0% at six months, compared to 3-5% with conventional total hip arthroplasty).7

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Orthopedics at Baylor Scott & White Health

At Baylor Scott & White Health, we offer expert subspecialty orthopedic care through the use of innovative therapies, minimally invasive surgeries, joint replacement, physical therapy and rehabilitation.

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References

  1. Duke University Center for Demographic Studies. Assessing the impact of medical technology innovations on human capital. Phase 1 final report (Part C): Effects of advanced medical technologies – Musculoskeletal diseases medical technology assessment working group: Prepared for the institute for medical technology innovation. January 2006.
  2. Kennedy J, Rogers W, Soffe K, Sullivan R, Griffen D, Sheehan L. Effect of acetabular component orientation on recurrent dislocation, pelvic osteolysis, polyethylene wear, and component migration. J Arthroplasty. 1998;13:53-534.
  3. Data on file. MAKO Surgical Corp.
  4. Malik A, Maheshwari A, Dorr L. Impingement with total hip replacement. J Bone Joint Surg Am.2007;89:1832-1842.
  5. Bozic K, Kurtz S, Lau E, Ong K, Vail T, Berry D. The epidemiology of revision total hip arthroplasty in the United States. J Bone Joint Surg Am. 2009;91:128-133.
  6. Nawabi DH, Conditt MA, Ranawat AS, Dunbar NJ, Jones J, Banks SA, Padgett DE. Haptically guided robotic technology in total hip arthroplasty – A cadaveric investigation. Jrl Eng Med.2013:227(3).
  7. Illgen R. Robotic assisted total hip arthroplasty improves accuracy and clinical outcome compared with manual technique. 43rd Annual Advances in Arthroplasty Course. October 22-25, 2013. Cambridge, MA.