Accuracy of acetabular cup positioning in robotic-assisted total hip arthroplasty: a CT-based evaluation
Introduction: Robot-assisted instrumentation during total hip arthroplasty (THA) has the potential to improve acetabular cup positioning. This study aimed to evaluate the precision of robotic-arm-assisted THA (rTHA) and assess whether the system can provide accurate cup positioning comparable to con...
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EDP Sciences
2024-01-01
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| Series: | SICOT-J |
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| author | Singh Ashish Kumar Purushotam Kalyan Kanukuntla Gundalli Akash Chandrashekar Mane Sudhir Shankar Swarnkar Himanshu Singh Lavanya |
| author_facet | Singh Ashish Kumar Purushotam Kalyan Kanukuntla Gundalli Akash Chandrashekar Mane Sudhir Shankar Swarnkar Himanshu Singh Lavanya |
| author_sort | Singh Ashish |
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| description | Introduction: Robot-assisted instrumentation during total hip arthroplasty (THA) has the potential to improve acetabular cup positioning. This study aimed to evaluate the precision of robotic-arm-assisted THA (rTHA) and assess whether the system can provide accurate cup positioning comparable to conventional THA (cTHA). Methods: A single-center prospective cohort study consisting of 151 patients who underwent THA (108 rTHA and 43 cTHA). The robotically assisted system was used to match the postoperative computed tomography (CT) image of the pelvis with the planned and intraoperative anatomical landmarks. The cTHA cohort underwent hip replacement using the standard manual procedure, with acetabular component locations assessed during and after surgery. Results: The rTHA cohort was significantly younger, but no other significant differences were found between the two cohorts in preoperative baseline data. In rTHA cohort, the planned inclination (40.0 ± 0.3°) closely matched the intraoperative (40.2 ± 2.7°; p = 0.54) and postoperative (40.7 ± 4.0°; p = 0.07) measurements. However, anteversion showed a significant increase from planned (19.4 ± 1.5°) to postoperative CT scan (28.7 ± 7.0°; p < 0.001). There was evidence of proportional bias in the measurements (p < 0.001). In the cTHA cohort, the mean inclination (43.1 ± 5.1°) did not show any significant change between the preoperative plans and postoperative assessments (p = 0.12); however, there was a remarkable change in the mean anteversion (17.6 ± 6.4°) between postoperative measurements and the preoperative plans (p < 0.001). The average anteversion in the preoperative plans did not differ remarkably between the rTHA and cTHA cohorts. However, the average inclination was substantially different between the two cohorts (p < 0.001). Both groups had no significant differences in the proportion of cups outside the referenced safe zones. Conclusion: The results suggest that while robotic-assisted guidance ensures consistent cup inclination, there may be more variability in achieving the planned anteversion, which warrants further investigation into the factors influencing postoperative changes in acetabular orientation. |
| format | Article |
| id | doaj-art-b3a5c292957a4473a5013e8b86fb38d6 |
| institution | Kabale University |
| issn | 2426-8887 |
| language | English |
| publishDate | 2024-01-01 |
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| series | SICOT-J |
| spelling | doaj-art-b3a5c292957a4473a5013e8b86fb38d62025-01-08T11:23:03ZengEDP SciencesSICOT-J2426-88872024-01-01105710.1051/sicotj/2024057sicotj240088Accuracy of acetabular cup positioning in robotic-assisted total hip arthroplasty: a CT-based evaluationSingh Ashish0https://orcid.org/0000-0002-7908-1098Kumar Purushotam1https://orcid.org/0000-0002-9936-6701Kalyan Kanukuntla2https://orcid.org/0009-0006-4130-4619Gundalli Akash Chandrashekar3https://orcid.org/0009-0003-1217-7559Mane Sudhir Shankar4https://orcid.org/0000-0002-8020-3099Swarnkar Himanshu5https://orcid.org/0000-0002-5923-3146Singh Lavanya6https://orcid.org/0009-0000-4838-0581Anup Institute of Orthopaedics & RehabilitationAnup Institute of Orthopaedics & RehabilitationAnup Institute of Orthopaedics & RehabilitationAnup Institute of Orthopaedics & RehabilitationAnup Institute of Orthopaedics & RehabilitationAnup Institute of Orthopaedics & RehabilitationThe Hazeley AcademyIntroduction: Robot-assisted instrumentation during total hip arthroplasty (THA) has the potential to improve acetabular cup positioning. This study aimed to evaluate the precision of robotic-arm-assisted THA (rTHA) and assess whether the system can provide accurate cup positioning comparable to conventional THA (cTHA). Methods: A single-center prospective cohort study consisting of 151 patients who underwent THA (108 rTHA and 43 cTHA). The robotically assisted system was used to match the postoperative computed tomography (CT) image of the pelvis with the planned and intraoperative anatomical landmarks. The cTHA cohort underwent hip replacement using the standard manual procedure, with acetabular component locations assessed during and after surgery. Results: The rTHA cohort was significantly younger, but no other significant differences were found between the two cohorts in preoperative baseline data. In rTHA cohort, the planned inclination (40.0 ± 0.3°) closely matched the intraoperative (40.2 ± 2.7°; p = 0.54) and postoperative (40.7 ± 4.0°; p = 0.07) measurements. However, anteversion showed a significant increase from planned (19.4 ± 1.5°) to postoperative CT scan (28.7 ± 7.0°; p < 0.001). There was evidence of proportional bias in the measurements (p < 0.001). In the cTHA cohort, the mean inclination (43.1 ± 5.1°) did not show any significant change between the preoperative plans and postoperative assessments (p = 0.12); however, there was a remarkable change in the mean anteversion (17.6 ± 6.4°) between postoperative measurements and the preoperative plans (p < 0.001). The average anteversion in the preoperative plans did not differ remarkably between the rTHA and cTHA cohorts. However, the average inclination was substantially different between the two cohorts (p < 0.001). Both groups had no significant differences in the proportion of cups outside the referenced safe zones. Conclusion: The results suggest that while robotic-assisted guidance ensures consistent cup inclination, there may be more variability in achieving the planned anteversion, which warrants further investigation into the factors influencing postoperative changes in acetabular orientation.https://www.sicot-j.org/articles/sicotj/full_html/2024/01/sicotj240088/sicotj240088.htmltotal hip arthroplastyacetabular cup positioningrobotic-assisted surgerypreoperative planningintraoperative planning |
| spellingShingle | Singh Ashish Kumar Purushotam Kalyan Kanukuntla Gundalli Akash Chandrashekar Mane Sudhir Shankar Swarnkar Himanshu Singh Lavanya Accuracy of acetabular cup positioning in robotic-assisted total hip arthroplasty: a CT-based evaluation SICOT-J total hip arthroplasty acetabular cup positioning robotic-assisted surgery preoperative planning intraoperative planning |
| title | Accuracy of acetabular cup positioning in robotic-assisted total hip arthroplasty: a CT-based evaluation |
| title_full | Accuracy of acetabular cup positioning in robotic-assisted total hip arthroplasty: a CT-based evaluation |
| title_fullStr | Accuracy of acetabular cup positioning in robotic-assisted total hip arthroplasty: a CT-based evaluation |
| title_full_unstemmed | Accuracy of acetabular cup positioning in robotic-assisted total hip arthroplasty: a CT-based evaluation |
| title_short | Accuracy of acetabular cup positioning in robotic-assisted total hip arthroplasty: a CT-based evaluation |
| title_sort | accuracy of acetabular cup positioning in robotic assisted total hip arthroplasty a ct based evaluation |
| topic | total hip arthroplasty acetabular cup positioning robotic-assisted surgery preoperative planning intraoperative planning |
| url | https://www.sicot-j.org/articles/sicotj/full_html/2024/01/sicotj240088/sicotj240088.html |
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