Comparing cup placement, leg length, and offset discrepancy after total hip arthroplasty between CT-based robotic arm-assisted and navigation systems
Aims: Excellent outcomes have been reported following CT-based robotic arm-assisted total hip arthroplasty (rTHA) compared with manual THA; however, its superiority over CT-based navigation THA (nTHA) remains unclear. This study aimed to determine whether a CT-based robotic arm-assisted system help...
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The British Editorial Society of Bone & Joint Surgery
2025-01-01
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| Series: | Bone & Joint Open |
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| Online Access: | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.61.BJO-2024-0173.R1 |
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| author | Akira Shimizu Satoshi Murakami Takayuki Tamai Yuuki Haga Tatsuhiko Kutsuna Tomofumi Kinoshita Masaki Takao |
| author_facet | Akira Shimizu Satoshi Murakami Takayuki Tamai Yuuki Haga Tatsuhiko Kutsuna Tomofumi Kinoshita Masaki Takao |
| author_sort | Akira Shimizu |
| collection | DOAJ |
| description | Aims: Excellent outcomes have been reported following CT-based robotic arm-assisted total hip arthroplasty (rTHA) compared with manual THA; however, its superiority over CT-based navigation THA (nTHA) remains unclear. This study aimed to determine whether a CT-based robotic arm-assisted system helps surgeons perform accurate cup placement, minimizes leg length, and offsets discrepancies more than a CT-based navigation system. Methods: We studied 60 hips from 54 patients who underwent rTHA between April 2021 and August 2023, and 45 hips from 44 patients who underwent nTHA between January 2020 and March 2021 with the same target cup orientation at the Department of Orthopedic Surgery at Ozu Memorial Hospital, Japan. After propensity score matching, each group had 37 hips. Postoperative acetabular component position and orientation were measured using the planning module of the CT-based navigation system. Postoperative leg length and offset discrepancies were evaluated using postoperative CT in patients who have unilateral hip osteoarthritis. Results: The absolute differences in radiological inclination (RI) and radiological anteversion (RA) from the target were significantly smaller in rTHA (RI 1.2° (SD 1.2°), RA 1.4° (SD 1.2°)) than in nTHA (RI 2.7° (SD 1.9°), RA 3.0° (SD 2.6°)) (p = 0.005 for RI, p = 0.002 for RA). The absolute distance of the target’s postoperative centre of rotation was significantly smaller in the mediolateral (ML) and superoinferior (SI) directions in rTHA (ML 1.1 mm (SD 0.8), SI 1.3 mm (SD 0.5)) than in nTHA (ML 1.9 mm (SD 0.9), SI 1.6 mm (SD 0.9)) (p = 0.002 for ML, p = 0.042 for SI). Absolute leg length and absolute discrepancies in the acetabular, femoral, and global offsets were significantly lower in the rTHA group than in the nTHA group (p = 0.042, p = 0.004, p = 0.003, and p = 0.010, respectively). In addition, the percentage of hips significantly differed with an absolute global offset discrepancy of ≤ 5 mm (p < 0.001). Conclusion: rTHA is more accurate in cup orientation and position than nTHA, effectively reducing postoperative leg length and offset discrepancy. Cite this article: Bone Jt Open 2024;6(1):3–11. |
| format | Article |
| id | doaj-art-34b0fab2e62a405794be964f0e79f6be |
| institution | Kabale University |
| issn | 2633-1462 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | The British Editorial Society of Bone & Joint Surgery |
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| series | Bone & Joint Open |
| spelling | doaj-art-34b0fab2e62a405794be964f0e79f6be2025-01-28T05:38:53ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Open2633-14622025-01-016131110.1302/2633-1462.61.BJO-2024-0173.R1Comparing cup placement, leg length, and offset discrepancy after total hip arthroplasty between CT-based robotic arm-assisted and navigation systemsAkira Shimizu0Satoshi Murakami1Takayuki Tamai2Yuuki Haga3Tatsuhiko Kutsuna4Tomofumi Kinoshita5https://orcid.org/0000-0001-6469-4652Masaki Takao6https://orcid.org/0000-0002-5626-9477Department of Orthopedic Surgery, Ozu Memorial Hospital, Ozu, JapanDepartment of Orthopedic Surgery, Ozu Memorial Hospital, Ozu, JapanDepartment of Orthopedic Surgery, Ozu Memorial Hospital, Ozu, JapanDepartment of Orthopedic Surgery, Ozu Memorial Hospital, Ozu, JapanDepartment of Orthopaedic Surgery, Ehime University Graduate School of Medicine, Toon, JapanDepartment of Orthopaedic Surgery, Ehime University Graduate School of Medicine, Toon, JapanDepartment of Orthopaedic Surgery, Ehime University Graduate School of Medicine, Toon, JapanAims: Excellent outcomes have been reported following CT-based robotic arm-assisted total hip arthroplasty (rTHA) compared with manual THA; however, its superiority over CT-based navigation THA (nTHA) remains unclear. This study aimed to determine whether a CT-based robotic arm-assisted system helps surgeons perform accurate cup placement, minimizes leg length, and offsets discrepancies more than a CT-based navigation system. Methods: We studied 60 hips from 54 patients who underwent rTHA between April 2021 and August 2023, and 45 hips from 44 patients who underwent nTHA between January 2020 and March 2021 with the same target cup orientation at the Department of Orthopedic Surgery at Ozu Memorial Hospital, Japan. After propensity score matching, each group had 37 hips. Postoperative acetabular component position and orientation were measured using the planning module of the CT-based navigation system. Postoperative leg length and offset discrepancies were evaluated using postoperative CT in patients who have unilateral hip osteoarthritis. Results: The absolute differences in radiological inclination (RI) and radiological anteversion (RA) from the target were significantly smaller in rTHA (RI 1.2° (SD 1.2°), RA 1.4° (SD 1.2°)) than in nTHA (RI 2.7° (SD 1.9°), RA 3.0° (SD 2.6°)) (p = 0.005 for RI, p = 0.002 for RA). The absolute distance of the target’s postoperative centre of rotation was significantly smaller in the mediolateral (ML) and superoinferior (SI) directions in rTHA (ML 1.1 mm (SD 0.8), SI 1.3 mm (SD 0.5)) than in nTHA (ML 1.9 mm (SD 0.9), SI 1.6 mm (SD 0.9)) (p = 0.002 for ML, p = 0.042 for SI). Absolute leg length and absolute discrepancies in the acetabular, femoral, and global offsets were significantly lower in the rTHA group than in the nTHA group (p = 0.042, p = 0.004, p = 0.003, and p = 0.010, respectively). In addition, the percentage of hips significantly differed with an absolute global offset discrepancy of ≤ 5 mm (p < 0.001). Conclusion: rTHA is more accurate in cup orientation and position than nTHA, effectively reducing postoperative leg length and offset discrepancy. Cite this article: Bone Jt Open 2024;6(1):3–11.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.61.BJO-2024-0173.R1total hip arthroplastyrobotic arm-assisted systemct-based navigation systemleg length discrepancyoffset discrepancytotal hip arthroplasty (tha)robotic armsleg lengthhipspropensity score matchinghip osteoarthritisorthopedic surgeryacetabular component positionhip jointsdevelopmental dysplasia of the hip (ddh) |
| spellingShingle | Akira Shimizu Satoshi Murakami Takayuki Tamai Yuuki Haga Tatsuhiko Kutsuna Tomofumi Kinoshita Masaki Takao Comparing cup placement, leg length, and offset discrepancy after total hip arthroplasty between CT-based robotic arm-assisted and navigation systems Bone & Joint Open total hip arthroplasty robotic arm-assisted system ct-based navigation system leg length discrepancy offset discrepancy total hip arthroplasty (tha) robotic arms leg length hips propensity score matching hip osteoarthritis orthopedic surgery acetabular component position hip joints developmental dysplasia of the hip (ddh) |
| title | Comparing cup placement, leg length, and offset discrepancy after total hip arthroplasty between CT-based robotic arm-assisted and navigation systems |
| title_full | Comparing cup placement, leg length, and offset discrepancy after total hip arthroplasty between CT-based robotic arm-assisted and navigation systems |
| title_fullStr | Comparing cup placement, leg length, and offset discrepancy after total hip arthroplasty between CT-based robotic arm-assisted and navigation systems |
| title_full_unstemmed | Comparing cup placement, leg length, and offset discrepancy after total hip arthroplasty between CT-based robotic arm-assisted and navigation systems |
| title_short | Comparing cup placement, leg length, and offset discrepancy after total hip arthroplasty between CT-based robotic arm-assisted and navigation systems |
| title_sort | comparing cup placement leg length and offset discrepancy after total hip arthroplasty between ct based robotic arm assisted and navigation systems |
| topic | total hip arthroplasty robotic arm-assisted system ct-based navigation system leg length discrepancy offset discrepancy total hip arthroplasty (tha) robotic arms leg length hips propensity score matching hip osteoarthritis orthopedic surgery acetabular component position hip joints developmental dysplasia of the hip (ddh) |
| url | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.61.BJO-2024-0173.R1 |
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