J Korean Hip Soc.  2011 Dec;23(4):229-236. 10.5371/jkhs.2011.23.4.229.

Computer-Assisted Total Hip Arthroplasty

Affiliations
  • 1Department of Orthopaedic Surgery, Kyung Hee University School of Medicine, Seoul, Korea. drkim@khu.ac.kr

Abstract

Despite the overall satisfactory results of total hip arthroplasty, post-operative complications continue to occur. To minimize these problems, computer-assisted total hip arthroplasty using navigation or robot-assisted systems is being developed. A navigation system is defined as a system that locates a position in three-dimensional space and traces the target spot, and a robot-assisted system is defined as a system that performs operations automatically with mechanical robot arms based on prior preoperative planning. Computer-assisted surgeries have shown superior results to conventional methods in implant positioning, fixation, and accurate lower extremity alignment in the limited reports available. However, computer-assisted surgeries take longer compared to conventional methods. Due to the extra time needed, the risk of postoperative infection and blood loss is considered to be higher. Nevertheless, robot-assisted system is being developed for the field of hip arthroplasty, and thus its efficacy and accuracy needs to be further investigated. Since these methods have other advantages compared to conventional methods, they are the focus of much interest.

Keyword

Hip; Total hip arthroplasty; Computer-assisted orthopaedic surgery; Robot-assisted; Navigation

MeSH Terms

Arm
Arthroplasty
Hip
Lower Extremity
Surgery, Computer-Assisted

Figure

  • Fig. 1 The robot monitor shows bone milling procedure according to the preoperative planning.

  • Fig. 2 (A) After incise the skin as a routine manner and expose the acetabulum, the cotyloid fossa and acetabular surface, indluding margin, must be acquired using multiple landmark acquisition. (B) To begin multiple landmark acquisition, hold the tip of the pointer to the required structure and pivot it slightly. The location of the points is a key factor in a proper matching to ensure in every steps. Acquire points by sliding the pointer tip along the defined structure. (C) One the bone model has been calculated in the navigation monitor, verify the pelvis registration immediately.

  • Fig. 3 (A) The bone should be securely fixed with robot machine with fixator and the soft tissue should be retracted safely. (B) The milling procedure by robot is carrying out with monitoring of bone motion.

  • Fig. 4 (A) The planned inclination and version values for the implant are shown during reaming and the values are updated dynamically. (B) One the reamer has been navigated to the planned position and reaming has been completed, a trial cup is usually used to confirm that the selected cup size is correct.


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