OrthoSuperSite—March 9, 2012
In a recent crossfire debate, Douglas E. Padgett, MD, argued that orthopedists should use robotic-guided navigation during total hip replacement to ensure accurate component positioning. Other doctors have countered that too many questions about the technology remain for widespread use including efficacy, time, cost and potential risks.
“We need to currently use available technology,” Padgett said during the debate at the Current Concepts in Joint Replacement Winter 2011 Meeting in Orlando, Fla. “I think total hip should certainly enter its own new information age, and enhanced technology will allow us to customize hip arthroplasty for each one of our patients.”
Advantages of the technology
Robotic arm-guided total hip arthroplasty (THA) would increase accuracy during component positioning, Padgett said. In a study of 2,000 conventional THAs performed at Massachusetts General Hospital, Padgett and colleagues found that 50% of cups were positioned within the acceptable ranges of 25° anteversion and 40° abduction.
“[Robotics] combine the visual guidance afforded by navigation with the tactile feedback of robotics,” he said. “It is a semi-passive or haptic technology relying on touch defining the boundaries.”
Using robotic arm-guided THA technology enhances preoperative planning and bone preparation, and provides reproducible implant positioning, leg length and offset, Padgett said.
“Despite beating on it with a 20-pound mallet, consistent orientation, both abduction and anteversion, are obtained,” he said. “We know exactly where the hip is going to wind up.”
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