Robotic-Arm Assisted Total Hip Arthroplasty Results in Smaller Acetabular Cup Size in Relation to the Femoral Head Size: A Matched-Pair Controlled Study
Restricted accessResearch articleFirst published online March, 2017
Robotic-Arm Assisted Total Hip Arthroplasty Results in Smaller Acetabular Cup Size in Relation to the Femoral Head Size: A Matched-Pair Controlled Study
To compare the acetabular component size relative to the patient's native femoral head size between conventional THA (CTHA) approach and robotic-arm assisted THA (RTHA) to infer which of these techniques preserved more acetabular bone.
Methods
Patients were included if they had primary osteoarthritis (OA) and underwent total hip replacement between June 2008 and March 2014. Patients were excluded if they had missing or rotated postoperative anteroposterior radiographs. RTHA patients were matched to a control group of CTHA patients, in terms of preoperative native femoral head size, age, gender, body mass index (BMI) and approach. Acetabular cup size relative to femoral head size was used as a surrogate for amount of bone resected. We compared the groups according to 2 measures describing acetabular cup diameter (c) in relation to femoral head diameter (f): (i) c-f, the difference between cup diameter and femoral head diameter and (ii) (c-f)/f, the same difference as a fraction of femoral head diameter.
Results
57 matched pairs were included in each group. There were no significant differences between groups for demographic measures, femoral head diameter, or acetabular cup diameter (p>0.05). However, measures (i) and (ii) did differ significantly between the groups, with lower values in the RTHA group (p<0.02).
Conclusions
Using acetabular cup size relative to femoral head size as an approximate surrogate measure of acetabular bone resection may suggest greater preservation of bone stock using RTHA compared to CTHA. Further studies are needed to validate the relationship between acetabular cup size and bone loss in THA.
GandhiR., TsvetkovD., DhottarH., DaveyJ.R., MahomedN.N.Quantifying the pain experience in hip and knee osteoarthritis.Pain Res Manag.2010; 15(4): 224–228.
3.
AdelaniM.A., CrookK., BarrackR.L., MaloneyW.J., ClohisyJ.C.What is the prognosis of revision total hip arthroplasty in patients 55 years and younger?Clin Orthop Relat Res.2014; 472(5): 1518–1525.
4.
GirardJ., LavigneM., VendittoliP.A., RoyA.G.Biomechanical reconstruction of the hip: a randomised study comparing total hip resurfacing and total hip arthroplasty.J Bone Joint Surg Br.2006; 88(6): 721–726.
Australian Orthopaedic Association National Joint Replacement Registry. Annual Report 2015 Hip and Knee Arthroplasty. https://aoanjrr.sahmri.com/annual-reports-2015. Accessed February 13, 2015.
7.
KamaricA.J., NobleE.The accuracy of the acetabular reaming in total hip replacement. 45th Annual Meeting, Orthopaedic Research Society, Feb 1-4, 1999, Anaheim, California.
8.
MalikA., MaheshwariA., DorrL.D.Impingement with total hip replacement.J Bone Joint Surg Am.2007; 89(8): 1832–1842.
9.
TakigamiI., ItoY., MizoguchiT., ShimizuK.Pelvic Discontinuity Caused by Acetabular Overreaming during Primary Total Hip Arthroplasty.Case Rep Orthop.2011; 2011: 939202.
10.
KalteisT., HandelM., BäthisH., PerlickL., TingartM., GrifkaJ.Imageless navigation for insertion of the acetabular component in total hip arthroplasty: is it as accurate as CT-based navigation?J Bone Joint Surg Br.2006; 88(2): 163–167.
11.
LeendersT., VandeveldeD., MahieuG., NuytsR.Reduction in variability of acetabular cup abduction using computer assisted surgery: a prospective and randomized study.Comput Aided Surg.2002; 7(2): 99–106.
12.
ParratteS., ArgensonJ.N.Validation and usefulness of a computer-assisted cup-positioning system in total hip arthroplasty. A prospective, randomized, controlled study.J Bone Joint Surg Am.2007; 89(3): 494–499.
13.
TarwalaR., DorrL.D.Robotic assisted total hip arthroplasty using the MAKO platform.Curr Rev Musculoskelet Med.2011; 4(3): 151–156.
14.
YbingerT., KumpanW., HoffartH.E., MuschalikB., BullmannW., ZweymüllerK.Accuracy of navigation-assisted acetabular component positioning studied by computed tomography measurements: methods and results.J Arthroplasty.2007; 22(6): 812–817.
15.
SiebenrockK.A., KalbermattenD.F., GanzR.Effect of pelvic tilt on acetabular retroversion: a study of pelves from cadavers.Clin Orthop Relat Res.2003; 407: 241–248.
16.
CrossM.B., DolanM.M., SidhuG.S., NguyenJ., MaymanD.J., SuE.P.The removal of acetabular bone in hip resurfacing and cementless total hip replacement: a comparison using the ratio of the size of the acetabular component to the diameter of the native femoral head.J Bone Joint Surg Br.2012; 94(10): 1339–1343.
17.
VendittoliP-A, LavigneM., GirardJ., RoyA.G.A randomised study comparing resection of acetabular bone at resurfacing and total hip replacement.J Bone Joint Surg Br.2006; 88(8): 997–1002.
18.
LougheadJ.M., StarksI., ChesneyD., MatthewsJ.N.S., McCaskieA.W., HollandJ.P.Removal of acetabular bone in resurfacing arthroplasty of the hip: a comparison with hybrid total hip arthroplasty.J Bone Joint Surg Br.2006; 88(1): 31–34.
19.
ClohisyJ.C., CarlisleJ.C., BeauléP.E.. A systematic approach to the plain radiographic evaluation of the young adult hip.J Bone Joint Surg Am.2008; 90(Suppl 4): 47–66.
20.
HavelinL.I., EngesaeterL.B., EspehaugB., FurnesO., LieS.A., VollsetS.E.The Norwegian Arthroplasty Register: 11 years and 73,000 arthroplasties.Acta Orthop Scand.2000; 71(4): 337–353.
21.
HossainM., LewisJ., SinhaA.Digital pre-operative templating is more accurate in total hip replacement compared to analogue templating.Eur J Orthop Surg Traumatol.2008; 18(8): 577–580.
22.
MurzicW.J., GlozmanZ., LoweP.Digital templating in total hip replacement.US Musculoskeletal Rev.2006; 89: 25–27.
23.
LavigneM., RamaR.K., GanapathiM., NuñoN., WinzenriethR., VendittoliP.A.Factors affecting acetabular bone loss during primary hip arthroplasty—a quantitative analysis using computer simulation.Clin Biomech (Bristol, Avon).2008; 23(5): 577–583.
24.
NaalF.D., KainM.S., HerscheO., MunzingerU., LeunigM.Does hip resurfacing require larger acetabular cups than conventional THA?Clin Orthop Relat Res.2009; 467(4): 923–928.
25.
XenosJ.S., CallaghanJ.J., HeekinR.D., HopkinsonW.J., SavoryC.G., MooreM.S.The porous-coated anatomic total hip prosthesis, inserted without cement. A prospective study with a minimum of ten years of follow-up.J Bone Joint Surg Am.1999; 81(1): 74–82.
26.
PulidoL., RachalaS.R., CabanelaM.E.Cementless acetabular revision: past, present, and future. Revision total hip arthroplasty: the acetabular side using cementless implants.Int Orthop.2011; 35(2): 289–298.
27.
KohK.H., MoonY.W., LimS.J., LeeH.I., ShimJ.W., ParkY.S.Complete acetabular cup revision versus isolated liner exchange for polyethylene wear and osteolysis without loosening in cementless total hip arthroplasty.Arch Orthop Trauma Surg.2011; 131(11): 1591–1600.
28.
MäkeläK.T., EskelinenA., PulkkinenP., PaavolainenP., RemesV.Total hip arthroplasty for primary osteoarthritis in patients fifty-five years of age or older. An analysis of the Finnish arthroplasty registry.J Bone Joint Surg Am.2008; 90(10): 2160–2170.
29.
BrennanS.A., HartyJ.A., GormleyC., O'RourkeS.K.Comparison of acetabular reamings during hip resurfacing versus uncemented total hip arthroplasty.J Orthop Surg (Hong Kong).2009; 17(1): 42–46.
30.
CrawfordJ.R., PalmerS.J., WimhurstJ.A., VillarR.N.Bone loss at hip resurfacing: a comparison with total hip arthroplasty.Hip Int.2005; 15(4): 195–198.
31.
MoonotP., SinghP.J., CroninM.D., KalairajahY.E., KavanaghT.G., FieldR.E.Birmingham hip resurfacing: is acetabular bone conserved?J Bone Joint Surg Br.2008; 90(3): 319–323.
32.
SuE.P., SheehanM., SuS.L.Comparison of bone removed during total hip arthroplasty with a resurfacing or conventional femoral component: a cadaveric study.J Arthroplasty.2010; 25(2): 325–329.
33.
DombB.G., RedmondJ.M., LouisS.S.. Accuracy of component positioning in 1980 total hip arthroplasties: a comparative analysis by surgical technique and mode of guidance.J Arthroplasty.2015; 30(12): 2208–2218.
