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Comparison of the accuracy of the cup position and orientation in total hip arthroplasty for osteoarthritis secondary to developmental dysplasia of the hip between the Mako robotic arm-assisted system and computed tomography-based navigation

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Abstract

Purpose

We investigated the accuracy of the acetabular cup position and orientation in robotic-assisted total hip arthroplasty (rTHA) compared to navigated THA (nTHA) using computed tomography (CT) for patients with osteoarthritis secondary to developmental dysplasia of the hip (DDH).

Methods

We studied 31 hips of 28 patients who underwent rTHA and 119 hips of 112 patients who underwent nTHA with the same target cup orientation. After propensity score matching, each group comprised 29 hips. Post-operative cup position and orientation were measured from the postoperative CT data. Errors from the target cup position and orientation were compared between the two groups.

Results

Post-operatively, the absolute error of the anteroposterior and superoinferior cup positions from the target position was significantly lower in the rTHA group than in the nTHA group. The change in the post-operative radiographic inclination from the target orientation was lower in the rTHA group than in the nTHA group. Screw fixation for cup implantation was required for three hips in the nTHA group but not in the rTHA group.

Conclusion

rTHA achieved more precise cup implantation with reduced variation from the target orientation compared to nTHA in patients with osteoarthritis secondary to DDH.

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Availability of data and materials

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data is not available.

References

  1. Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR (1978) Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am 60:217–220

    Article  CAS  PubMed  Google Scholar 

  2. D'Lima DD, Urquhart AG, Buehler KO, Walker RH, Colwell CW Jr (2000) The effect of the orientation of the acetabular and femoral components on the range of motion of the hip at different head-neck ratios. J Bone Joint Surg Am 82:315–321. https://doi.org/10.2106/00004623-200003000-00003

    Article  CAS  PubMed  Google Scholar 

  3. Kennedy JG, Rogers WB, Soffe KE, Sullivan RJ, Griffen DG, Sheehan LJ (1998) Effect of acetabular component orientation on recurrent dislocation, pelvic osteolysis, polyethylene wear, and component migration. J Arthroplast 13:530–534. https://doi.org/10.1016/s0883-5403(98)90052-3

    Article  CAS  Google Scholar 

  4. DiGioia AM 3rd, Jaramaz B, Colgan BD (1998) Computer assisted orthopaedic surgery. Image guided and robotic assistive technologies. Clin Orthop Relat Res 354:8–16

    Article  Google Scholar 

  5. Digioia AM 3rd, Jaramaz B, Plakseychuk AY, Moody JE Jr, Nikou C, Labarca RS, Levison TJ, Picard F (2002) Comparison of a mechanical acetabular alignment guide with computer placement of the socket. J Arthroplast 17:359–364. https://doi.org/10.1054/arth.2002.30411

    Article  Google Scholar 

  6. Pagkalos J, Chaudary MI, Davis ET (2014) Navigating the reaming of the acetabular cavity in total hip arthroplasty: does it improve implantation accuracy? J Arthroplast 29:1749–1752. https://doi.org/10.1016/j.arth.2014.03.038

    Article  Google Scholar 

  7. Lin F, Lim D, Wixson RL, Milos S, Hendrix RW, Makhsous M (2011) Limitations of imageless computer-assisted navigation for total hip arthroplasty. J Arthroplast 26:596–605. https://doi.org/10.1016/j.arth.2010.05.027

    Article  Google Scholar 

  8. Wasterlain AS, Buza JA 3rd, Thakkar SC, Schwarzkopf R, Vigdorchik J (2017) Navigation and Robotics in Total Hip Arthroplasty. JBJS Rev 5(3):01874474-201703000-00005

    Article  Google Scholar 

  9. Domb BG, El Bitar YF, Sadik AY, Stake CE, Botser IB (2014) Comparison of robotic-assisted and conventional acetabular cup placement in THA: a matched-pair controlled study. Clin Orthop Relat Res 472:329–336. https://doi.org/10.1007/s11999-013-3253-7

    Article  PubMed  Google Scholar 

  10. Elmallah RK, Cherian JJ, Jauregui JJ, Padden DA, Harwin SF, Mont MA (2015) Robotic-arm assisted surgery in total hip arthroplasty. Surg Technol Int 26:283–288

    PubMed  Google Scholar 

  11. Elson L, Dounchis J, Illgen R, Marchand RC, Padgett DE, Bragdon CR, Malchau H (2015) Precision of acetabular cup placement in robotic integrated total hip arthroplasty. Hip Int 25:531–536. https://doi.org/10.5301/hipint.5000289

    Article  PubMed  Google Scholar 

  12. Harris WH, Hampton BJ (2007) Total hip arthroplasty in the management of arthritis secondary to developmental dysplasia of the hip. In: Callaghan JJ, Rosenberg AG, Rubash HE (eds) The Adult hip, 2nd edn. Lippincott Williams & Wilkins, Philadelphia, p 1127

    Google Scholar 

  13. Crowe JF, Mani VJ, Ranawat CS (1979) Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am 61:15–23

    Article  CAS  PubMed  Google Scholar 

  14. Takao M, Nakamura N, Ohzono K, Sakai T, Nishii T, Sugano N (2011) The results of a press-fit-only technique for acetabular fixation in hip dysplasia. J Arthroplast 26:562–568. https://doi.org/10.1016/j.arth.2010.05.025

    Article  Google Scholar 

  15. Sugano N (2013) Computer-assisted orthopaedic surgery and robotic surgery in total hip arthroplasty. Clin Orthop Surg 5:1–9. https://doi.org/10.4055/cios.2013.5.1.1

    Article  PubMed  PubMed Central  Google Scholar 

  16. Kitada M, Nakamura N, Iwana D, Kakimoto A, Nishii T, Sugano N (2011) Evaluation of the accuracy of computed tomography-based navigation for femoral stem orientation and leg length discrepancy. J Arthroplast 26:674–679. https://doi.org/10.1016/j.arth.2010.08.001

    Article  Google Scholar 

  17. Iwana D, Nakamura N, Miki H, Kitada M, Hananouchi T, Sugano N (2013) Accuracy of angle and position of the cup using computed tomography-based navigation systems in total hip arthroplasty. Comput Aided Surg 18:187–194. https://doi.org/10.3109/10929088.2013.818713

    Article  PubMed  Google Scholar 

  18. Faul F, Erdfelder E, Lang AG, Buchner A (2007) G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 39:175–191. https://doi.org/10.3758/bf03193146

    Article  PubMed  Google Scholar 

  19. Callanan MC, Jarrett B, Bragdon CR, Zurakowski D, Rubash HE, Freiberg AA, Malchau H (2011) The John Charnley Award: risk factors for cup malpositioning: quality improvement through a joint registry at a tertiary hospital. Clin Orthop Relat Res 469:319–329. https://doi.org/10.1007/s00264-013-2271-0

    Article  PubMed  Google Scholar 

  20. Nodzo SR, Chang CC, Carroll KM, Barlow BT, Banks SA, Padgett DE, Mayman DJ, Jerabek SA (2018) Intraoperative placement of total hip arthroplasty components with robotic-arm assisted technology correlates with postoperative implant position: a CT-based study. Bone Joint J 100-B:1303–1309. https://doi.org/10.1302/0301-620X.100B10-BJJ-2018-0201.R1

    Article  CAS  PubMed  Google Scholar 

  21. Nishii T, Sakai T, Takao M, Sugano N (2015) Fluctuation of cup orientation during press-fit insertion: a possible cause of malpositioning. J Arthroplast 30:1847–1851. https://doi.org/10.1016/j.arth.2015.04.037

    Article  Google Scholar 

  22. Fujishiro T, Hayashi S, Kanzaki N, Hashimoto S, Shibanuma N, Kurosaka M (2014) Effect of screw fixation on acetabular component alignment change in total hip arthroplasty. Int Orthop 38:1155–1158. https://doi.org/10.1007/s00264-013-2271-0

    Article  PubMed  PubMed Central  Google Scholar 

  23. Kanawade V, Dorr LD, Banks SA, Zhang Z, Wan Z (2015) Precision of robotic guided instrumentation for acetabular component positioning. J Arthroplast 30:392–397. https://doi.org/10.1016/j.arth.2014.10.021

    Article  Google Scholar 

  24. Sugano N, Takao M, Sakai T, Nishii T, Miki H (2012) Does CT-based navigation improve the long-term survival in ceramic-on-ceramic THA? Clin Orthop Relat Res 470:3054–3059. https://doi.org/10.1007/s11999-012-2378-4

    Article  PubMed  PubMed Central  Google Scholar 

  25. Pirruccio K, Premkumar A, Sheth NP (2020) The burden of prosthetic hip dislocations in the United States is projected to significantly increase by 2035. Hip Int 11:1120700020923619. https://doi.org/10.1177/1120700020923619

    Article  Google Scholar 

  26. Gwam CU, Mistry JB, Mohamed NS, Thomas M, Bigart KC, Mont MA, Delanois RE (2017) Current epidemiology of revision total hip arthroplasty in the United States: national inpatient sample 2009 to 2013. J Arthroplast 32:2088–2092. https://doi.org/10.1016/j.arth.2017.02.046

    Article  Google Scholar 

  27. Van Steenbergen LN, M eenb KT, K eenber J, Rolfson O, Overgaard S, Furnes O, Pedersen AB, Eskelinen A, Hallan G, Schreurs BW, Nelissen RGHH (2020) Total hip arthroplasties in the Dutch Arthroplasty Register (LROI) and the Nordic Arthroplasty Register Association (NARA): comparison of patient and procedure characteristics in 475,685 cases. Acta Orthop 10:1–7. https://doi.org/10.1080/17453674.2020.1843875

    Article  Google Scholar 

  28. Domb BG, Chen JW, Lall AC, Perets I, Maldonado DR (2020) Minimum 5-year outcomes of robotic-assisted primary total hip arthroplasty with a nested comparison against manual primary total hip arthroplasty: a propensity score-matched study. J Am Acad Orthop Surg. https://doi.org/10.5435/JAAOS-D-19-00328

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Authors and Affiliations

  1. Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Wataru Ando, Keisuke Uemura & Nobuhiko Sugano

  2. Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan

    Masaki Takao & Hidetoshi Hamada

Authors
  1. Wataru Ando
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  2. Masaki Takao
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  3. Hidetoshi Hamada
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  4. Keisuke Uemura
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  5. Nobuhiko Sugano
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Contributions

WA had contributed to data collection, data analysis, as well as manuscript preparation. MT and HH had contributed to surgery and data collection and manuscript editing. KU had contributed to data collection, data analysis, and manuscript editing. NS had contributed to planning, surgery, data analysis, as well as manuscript editing.

Corresponding author

Correspondence to Nobuhiko Sugano.

Ethics declarations

Ethical approval

This was a retrospective study and all procedures involving human participants were in accordance with the ethical standards of the institutional research committee in our institutions (the ethics committee of Osaka University Graduate School of Medicine, reference number: 18479) and the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Consent to participate and consent to publish

All subjects in this study were informed of the study protocol and written informed consent to participate and publish was obtained.

Conflict of interest

WA, MT and NS received the Speakers bureau/paid presentations for a company or supplier from Stryker. HH and KU declared no conflicts of interest to be stated for this study.

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Ando, W., Takao, M., Hamada, H. et al. Comparison of the accuracy of the cup position and orientation in total hip arthroplasty for osteoarthritis secondary to developmental dysplasia of the hip between the Mako robotic arm-assisted system and computed tomography-based navigation. International Orthopaedics (SICOT) 45, 1719–1725 (2021). https://doi.org/10.1007/s00264-021-05015-3

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