Robotic-Assisted Triple Reaming Technique for Total Hip Arthroplasty in Protrusio Acetabuli.

We describe a robotic-assisted triple reaming technique during total hip arthroplasty in protrusio acetabuli. This technique uses computerized tomography-based 3-dimensional preoperative planning and intraoperative dynamic referencing to prepare the acetabulum. Two separate surgical plans are created using the robotic workflow. Using the first plan, the protrusio defect is prepared utilizing a reamer that matches the size and location of the defect. Using the second plan, the true acetabulum is reamed, using a reamer that restores the hip center and provides an adequate rim fit. Thirdly, the impacted bone grafts are also reverse reamed using the second plan. The 3-step sequential reaming as well as final insertion of the acetabular component are performed with real-time robotic feedback. The robotic-assisted triple reaming technique can facilitate restoring the hip biomechanics in protrusio acetabuli.