Vigdorchik Jonathan M, Sharma Abhinav K, Aggarwal Vinay K, Carroll Kaitlin M, Jerabek Seth A
Department of Orthopedic Surgery, Hospital for Special Surgery, Adult Reconstruction and Joint Replacement Service, New York, NY, USA.
Department of Orthopedic Surgery, NYU Langone Health, Division of Adult Reconstruction, New York, NY, USA.
Arthroplast Today. 2020 Sep 8;6(4):770-776. doi: 10.1016/j.artd.2020.07.022. eCollection 2020 Dec.
Total hip arthroplasty (THA) is an effective operation for patients with hip osteoarthritis; however, patients with hip dysplasia present a particular challenge. Our novel study examined the effect of robot-assisted THA in patients with hip dysplasia.
We retrospectively reviewed patients with developmental dysplasia of the hip undergoing primary THA using robotic arm assistance at 2 institutions from January 2010 to January 2017. Patients undergoing revision arthroplasty were excluded. Preoperatively, all patients underwent a computed tomography scan so that 3-dimensional templating could be performed. Hip range of motion (ROM) and clinical leg length discrepancy were recorded preoperatively. Two independent observers calculated Crowe and Hartofilakidis grades for each operative hip. At the final follow-up, hip ROM, postoperative complications, and modified Harris Hip scores were obtained.
Seventy-nine patients underwent THA because of degenerative joint disease in the setting of developmental dysplasia of the hip. There were 56 females and 23 males with a mean age of 45 years (range: 26-64 years). We found that components were placed according to the preoperative plan, that there was an improvement in the modified Harris hip score from 29 to 86 ( < .001), an improvement in the hip ROM (flexion improvement from 66° to 91°, < .0001), and a correction of leg length discrepancy (17.1 vs 4 mm, < .0002). There were no complications during the short-term interim follow-up (mean: 3.1 years).
Robot-assisted THA can be a useful method to ensure adequate component positioning and excellent outcomes in patients with hip dysplasia.
Level III, Retrospective.
全髋关节置换术(THA)对髋骨关节炎患者是一种有效的手术;然而,髋关节发育不良的患者面临着特殊的挑战。我们的新研究探讨了机器人辅助THA对髋关节发育不良患者的影响。
我们回顾性分析了2010年1月至2017年1月在2家机构接受机器人手臂辅助初次THA的髋关节发育不良患者。排除接受翻修置换术的患者。术前,所有患者均接受计算机断层扫描,以便进行三维模板测量。记录术前髋关节活动范围(ROM)和临床腿长差异。两名独立观察者计算每个手术髋关节的Crowe和Hartofilakidis分级。在最终随访时,获取髋关节ROM、术后并发症和改良Harris髋关节评分。
79例患者因髋关节发育不良合并退行性关节病接受了THA。其中女性56例,男性23例,平均年龄45岁(范围:26 - 64岁)。我们发现假体组件按照术前计划放置,改良Harris髋关节评分从29分提高到86分(P <.001),髋关节ROM得到改善(屈曲从66°提高到91°,P <.0001),腿长差异得到纠正(从17.1 mm降至4 mm,P <.0002)。短期中期随访(平均:3.1年)期间无并发症发生。
机器人辅助THA对于确保髋关节发育不良患者假体组件的适当定位和良好预后可能是一种有用的方法。
III级,回顾性研究。