Comparing cup placement, leg length, and offset discrepancy after total hip arthroplasty between CT-based robotic arm-assisted and navigation systems.

IF 2.8 Q1 ORTHOPEDICS

Bone & Joint Open Pub Date : 2025-01-01 DOI:10.1302/2633-1462.61.BJO-2024-0173.R1

Akira Shimizu, Satoshi Murakami, Takayuki Tamai, Yuuki Haga, Tatsuhiko Kutsuna, Tomofumi Kinoshita, Masaki Takao

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Abstract

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.

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比较基于ct的机械臂辅助系统和导航系统在全髋关节置换术后杯子放置、腿长和偏移量差异。

目的：与人工全髋关节置换术相比，基于ct的机械臂辅助全髋关节置换术（rTHA）的预后较好；然而，它相对于基于ct的导航THA （nTHA）的优势尚不清楚。本研究旨在确定基于ct的机械臂辅助系统是否能帮助外科医生准确放置杯子，最大限度地减少腿长，并比基于ct的导航系统更能抵消差异。方法：我们研究了2021年4月至2023年8月期间54例rTHA患者的60个髋关节，以及2020年1月至2021年3月期间44例nTHA患者的45个髋关节，这些患者在日本小津纪念医院骨科手术中具有相同的靶杯方向。倾向评分匹配后，每组有37个髋部。使用基于ct的导航系统的规划模块测量术后髋臼组件的位置和方向。术后使用CT评估单侧髋关节骨关节炎患者的术后腿长和偏移差异。结果：rTHA组（RI 1.2°（SD 1.2°），RA 1.4°（SD 1.2°））相对于nTHA组（RI 2.7°（SD 1.9°），RA 3.0°（SD 2.6°））的放射倾斜度（RI）和放射前倾（RA）的绝对差异显著小于rTHA组（RI = 0.005, RA = 0.002）。在rTHA (ML 1.1 mm （SD 0.8), SI 1.3 mm (SD 0.5)）中外侧（ML）和上下（SI）方向上，术后目标旋转中心的绝对距离明显小于nTHA (ML 1.9 mm (SD 0.9), SI 1.6 mm (SD 0.9)) （ML = 0.002, SI = 0.042）。与nTHA组相比，rTHA组的绝对腿长和髋臼、股骨和整体偏置的绝对差异显著低于nTHA组（p = 0.042, p = 0.004, p = 0.003和p = 0.010）。此外，髋部百分比显著不同，绝对全球偏置差异≤5 mm （p < 0.001）。结论：rTHA比nTHA更准确的定位和定位，有效地减少了术后腿长和偏移量差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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