Abstract
Acetabular component malpositioning is a frequent cause of complications in total
hip arthroplasty including instability, increased wear, osteolysis, impingement, and
revision surgery. Recently, robotics and navigation have been introduced to improve
cup positioning in total hip arthroplasty. The purpose of this study was to compare
the accuracy of postoperative acetabular component positioning using MAKO robotic-assisted
versus manual acetabular component placement. A consecutive series of 100 total hip
replacements were performed in 100 patients. The first 50 were performed using manual
techniques, while the second 50 were performed using MAKO-guided acetabular component
placement. Postoperative anteroposterior pelvis radiographs were used to determine
the postoperative anteversion and inclination of the cup relative to the goal of 15
and 45°, respectively. In the manual group, the average anteversion and inclination
was 14.3 and 44.2°, respectively, with 28% within 5° and 82% within 10° of the goal
alignment, respectively. In the robotic group, the average anteversion and inclination
was 15.1 and 45.6°, respectively, with 54 and 88% within 5 and 10° of the goal alignment,
respectively. This equated to a statistically significant improvement in the number
of acetabular components placed within 5° of the target alignment with the use of
robotic guidance (p = 0.0142). From the authors' study, they were able to demonstrate a significant improvement
in acetabular component alignment with the use of robotic techniques. Additional studies
are needed to demonstrate improvement in clinical outcomes as a result of improved
accuracy and precision of acetabular component placement.
Keywords
primary THA - robotic-assisted THA - acetabular component alignment - anteversion
- inclination
