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A Comparison between Robotic-assisted and Manual Implantation of Cementless Total Hip Arthroplasty

  • Clinical Research
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Clinical Orthopaedics and Related Research®

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Abstract

Background

The benefits of robotic techniques for implanting femoral components during THA are still controversial.

Questions/Purposes

The purpose of this study was to prospectively compare the results and complications of robotic-assisted and hand-rasping stem implantation techniques.

Method

The minimum followup was 5 years (mean, 67 months; range, 60–85 months). One hundred forty-six primary THAs on 130 patients were included in this study. Robot-assisted primary THA was performed on 75 hips and a hand-rasping technique was used on 71 hips.

Results

At 2 and 3 years postoperatively, the Japanese Orthopaedic Association (JOA) clinical score was slightly better in the robotic-assisted group. At 5 years followup, however, the differences were not significant. Postoperative limb lengths of the robotic-milling group had significantly less variance than the hand-rasping group. At 2 years postoperatively, there was significantly more stress shielding of the proximal femur in the hand-rasping group; this difference was more significant 5 years postoperatively.

Conclusions

Substantially more precise implant positioning seems to have led to less variance in limb-length inequality and less stress shielding of the proximal femur 5 years postoperatively.

Level of Evidence

Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Author information

Authors and Affiliations

  1. Center of Arthroplasty, Kyowakai Hospital, 1-24-1 Kishibe-kita, Suita, Osaka, 564-0001, Japan

    Nobuo Nakamura MD & Akihiro Kakimoto MD

  2. Department of Orthopedic Surgery, Osaka University Medical School, Osaka, Japan

    Nobuhiko Sugano MD, Takashi Nishii MD & Hidenobu Miki MD

Authors
  1. Nobuo Nakamura MD
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  2. Nobuhiko Sugano MD
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  3. Takashi Nishii MD
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  4. Akihiro Kakimoto MD
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  5. Hidenobu Miki MD
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Corresponding author

Correspondence to Nobuo Nakamura MD.

Additional information

One or more of the authors (NN, NS) have received funding from Imatron Japan Inc.

Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at the Center of Arthroplasty, Kyowakai Hospital and Department of Orthopedic Surgery, Osaka University Medical School, Osaka, Japan.

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Nakamura, N., Sugano, N., Nishii, T. et al. A Comparison between Robotic-assisted and Manual Implantation of Cementless Total Hip Arthroplasty. Clin Orthop Relat Res 468, 1072–1081 (2010). https://doi.org/10.1007/s11999-009-1158-2

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  • DOI: https://doi.org/10.1007/s11999-009-1158-2

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