The current role of robotics in total hip arthroplasty

[摘要] The surgical treatment of symptomatic end-stage hip osteoarthritis has evolved over the last three hundred years from rudimentary excision surgery to modern robotic total hip arthroplasty (THA).1 Prior to the advent of modern anaesthesia, surgical treatment of hip osteoarthritis included proximal femoral resection or limb amputation.1,2 Increasing functional demands of patients and developments in general anaesthesia led to the creation of interposition arthroplasty in which skin, fascia lata, or submucosa from porcine bladder were placed between the articulating surfaces of the hip joint.1 Further advancements in the understanding of hip anatomy and joint biomechanics led to partial arthroplasties of the femoral head or native acetabulum with alloys of chromium, cobalt, and molybdenum.2 These procedures were associated with high risk of failure owing to poor implant designs and suboptimal mechanical properties of the metal components.2,3 In 1971, Charnley revolutionized THA through the introduction of low-friction arthroplasty, and his subsequent developments of acrylic cement to fix implants to living bone and high-density polyethylene as a bearing material.1 Analysis of these implants, using revision of either component as the endpoint, found implant survivorship of 77–82% at 20 years follow-up, and led to many surgeons heralding THA as the ‘operation of the century’.

[学科分类] 神经科学

[关键词] functional outcomes;hip biomechanics;implant positioning;robotics;total hip arthroplasty/replacement