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Is the Acetabular Cup Orientation Different in Robot-Assisted and Conventional Total Hip Arthroplasty With Right-Handed Surgeons Using an Anterolateral Approach?

作者信息

Kara Gokhan Kursat, Turan Kayhan, Eroglu Osman Nurı, Ozturk Cagatay, Ertürer Erden

机构信息

Orthopedics and Traumatology, Liv hospital Ulus, İstanbul, TUR.

Orthopedics and Traumatology, Atlas University, İstanbul, TUR.

出版信息

Cureus. 2023 Jul 23;15(7):e42335. doi: 10.7759/cureus.42335. eCollection 2023 Jul.


DOI:10.7759/cureus.42335
PMID:37614261
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10443961/
Abstract

Introduction Total hip arthroplasty (THA) is one of the most successful orthopaedic procedures. Survival rates from 90% at 10 years to 93% at 20 years have been reported in different studies. Differences in implant and patient characteristics can undoubtedly explain some of this variability observed in prosthesis durability, but the effect of surgical technique and implant orientation cannot be ignored. Therefore, many intraoperative methods (anatomic landmarks, intraoperative x-ray, fluoroscopy, navigation, and robotic surgery) have been attempted to avoid acetabular component malpositioning. Although postoperative computed tomography (CT) is accepted as the gold standard for the measurement of acetabular anteversion, it remains controversial in respect of costs and radiation exposure. The aim of this study was to examine how acetabular component orientation was affected in robotic and conventional THA operations performed by two surgeons with right-hand dominance. Material and methods The study included 113 primary THA operations performed on 113 patients between 2017 and 2022 in two groups: (i) robotic THA (Mako, Stryker Corporation, Kalamazoo, Michigan, United States) (55 patients) and (ii) conventional THA (58 patients). The patients comprised 51 males and 62 females. THA was performed on 54 right-side hips and 59 left-side hips. The operations were performed by two orthopaedic surgeons, each with 20 years of arthroplasty experience, on all the patients in the lateral decubitus position with an anterolateral approach. In all the cases, the orientation of the acetabular component was 40° inclination and 20° anteversion.  Difficult THA procedures (patients with developmental dysplasia of the hip (DDH), a history of hip surgery, revision THA, defect or deformity of the acetabulum, a history of scoliosis or lumbar posterior surgery, or those requiring proximal femoral osteotomy) were excluded from the study. Using the Liaw and Lewinnek methods, the acetabular component anteversion was measured on the radiographs taken in the optimal position postoperatively and the acetabular cup inclination angles were measured on the pelvis radiographs. The groups were compared using the Kolmogorov-Smirnov, Pearson Chi-square and Mann-Whitney U statistical tests. The limits were accepted as 40±5° for inclination and 20±5° for anteversion. Results No statistically significant difference was determined between the groups in respect of age, gender, or operated side. No statistically significant difference was determined between the optimal acetabular cup inclination angles of the robotic and conventional THA groups (p = 0.79). No statistically significant difference was determined between the optimal acetabular cup anteversion angles of the left and right conventional THA groups. Statistically significantly better results were determined in the robotic group in respect of acetabular cup anteversion (p<0,001).  Conclusion The optimal orientation of the acetabular component is a key factor for successful THA. Otherwise, revision surgery is inevitable for reasons such as instability, impingement, or increased wear. The results of this study demonstrated that robotic surgery was superior to the conventional method in the placement of the acetabular component in the desired orientation.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f76/10443961/147293f9e8d9/cureus-0015-00000042335-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f76/10443961/147293f9e8d9/cureus-0015-00000042335-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f76/10443961/147293f9e8d9/cureus-0015-00000042335-i01.jpg

相似文献

[1]
Is the Acetabular Cup Orientation Different in Robot-Assisted and Conventional Total Hip Arthroplasty With Right-Handed Surgeons Using an Anterolateral Approach?

Cureus. 2023-7-23

[2]
The Safe Zone Range for Cup Anteversion Is Narrower Than for Inclination in THA.

Clin Orthop Relat Res. 2018-2

[3]
[Comparative study of intra- and post-operative inclination and anteversion angles of acetabular cup in robot-assisted total hip arthroplasty].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021-10-15

[4]
Comparison of robotic-assisted and conventional acetabular cup placement in THA: a matched-pair controlled study.

Clin Orthop Relat Res. 2013-8-29

[5]
Adoption of Robotic vs Fluoroscopic Guidance in Total Hip Arthroplasty: Is Acetabular Positioning Improved in the Learning Curve?

J Arthroplasty. 2017-1

[6]
[Application of Mako robot-assisted total hip arthroplasty in developmental dysplasia of the hip].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021-10-15

[7]
Does Intra-operative Fluoroscopy Significantly Improve Component Position in a Primary Total Hip Arthroplasty? Our Experience in a Tertiary Care Hospital.

Indian J Orthop. 2022-12-28

[8]
Cementing a Monoblock Dual-Mobility Implant into a Fully Porous Cup in Revision Total Hip Arthroplasty to Address Hip Instability: Surgical Technique.

JBJS Essent Surg Tech. 2023-11-22

[9]
Robotic arm-assisted total hip arthroplasty via a minimally invasive anterolateral approach in the supine position improves the precision of cup placement in patients with developmental dysplasia of the hip.

J Orthop Sci. 2024-3

[10]
Acetabular cup placement and offset control in robotic total hip arthroplasty performed through the modified anterolateral approach.

Int Orthop. 2023-9

本文引用的文献

[1]
The area method for measuring acetabular cup anteversion: An accurate and autonomous solution.

J Clin Orthop Trauma. 2021-4-14

[2]
Surgical Approach and Hip Laterality Affect Accuracy of Acetabular Component Placement in Primary Total Hip Arthroplasty.

Surg Technol Int. 2019-11-10

[3]
Modern cup alignment techniques in total hip arthroplasty: A systematic review.

Orthop Traumatol Surg Res. 2019-5-1

[4]
Accuracy of plain antero-posterior radiographic-based methods for measurement of acetabular cup version.

Int Orthop. 2018-6-4

[5]
Is the cup orientation different in bilateral total hip arthroplasty with right-handed surgeons using posterolateral approach?

J Orthop Surg Res. 2018-5-23

[6]
The reliability of measuring acetabular component position on radiographs using everyday diagnostic imaging software.

J Orthop Surg (Hong Kong). 2017

[7]
Surgeons' Accuracy in Achieving Their Desired Acetabular Component Orientation.

J Bone Joint Surg Am. 2016-9-7

[8]
Adoption of Robotic vs Fluoroscopic Guidance in Total Hip Arthroplasty: Is Acetabular Positioning Improved in the Learning Curve?

J Arthroplasty. 2017-1

[9]
The learning curve associated with robotic-assisted total hip arthroplasty.

J Arthroplasty. 2015-1

[10]
Accuracy of acetabular component position in hip arthroplasty.

J Bone Joint Surg Am. 2013-10-2

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