Robotic Guidance in Total Hip Arthroplasty: The Shape of Things to Come

Abstract

Surgeons want to perform a perfect total hip arthroplasty (THA) with every operation. Human performance has limitations, especially when performing a mechanical operation in a biological environment. Recent suggested changes to improve outcomes have been large femoral heads and anterior incisions, but unfortunately, neither has resulted in any scientific data that change has been effected. The scientific data tell us that poor component positions and impingement are the source of increasing mechanical complications. Therefore, attempts have been made to improve the surgeon's performance by precise quantitative knowledge in the operating room. Robotic-guided navigation provides numerical data for cup inclination plus anteversion and center of rotation; femoral leg length and offset; and combined anteversion of the cup and stem. The acetabular bone preparation is done with a reamer connected to a robotic arm, which prevents human error by the surgeon of reaming off line or too deep. This technology provides predictable and reproducible results.