Impact of robot assistance on restoration of limb length and offset distance in total hip arthroplasty_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YUAN Ziqi ,  LI Yang , TIAN Hua

Department of Orthopedics, Peking University Third Hospital, Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, 100191, P. R. China;

Corresponding?author：

LI Yang, Email: liyangdr@bjmu.edu.cn

Keywords：

Robot-assisted surgery; total hip arthroplasty; limb length discrepancy; global offset

DOI：

10.7507/1002-1892.202405034

Video：

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Objective To analyze the impact of robot assistance on the restoration of limb length and offset distance in total hip arthroplasty (THA). Methods A retrospective analysis was conducted on the clinical data of 316 patients who underwent unilateral primary THA between September 2019 and August 2023. Among them, 117 patients underwent robot-assisted THA (group A), and 199 patients underwent conventional THA (group B). There was no significant difference between the two groups in the gender, age, or side of the hip replacement (P>0.05); but there was a significant difference in the preoperative diagnosis (P<0.05). The leg length discrepancy (LLD) and global offset (GO) dfference were measured on preoperative anteroposterior pelvic X-ray films, and absolute values were used for comparison between groups. Results The operations in both groups were successfully completed. Postoperative imaging measurements showed that the LLD and GO dfference in group A were significantly lower than those in group B (P<0.05). Among them, group A had 32 cases (27.4%), 5 cases (4.3%), and 0 case (0) of LLD>3 mm, >5 mm, and >10 mm, respectively, while group B had 115 cases (57.8%), 75 cases (37.7%), and 22 cases (11.1%), respectively; and the differences in above indicators between groups were significant (P<0.05). Group A had 40 cases (34.2%), 3 cases (2.6%), and 0 case (0) of GO dfference>5 mm, >10 mm, and >20 mm, respectively; group B had 103 cases (51.8%), 54 cases (27.1%), and 7 cases (3.5%), respectively. There was no significant difference in the proportion of patients with GO>20 mm between groups (P>0.05), while there were significant differences in other indicators between groups (P<0.05). Conclusion Compared with traditional THA, robot assisted THA has more advantages in restoration of limb length and offset distance.

Citation： YUAN Ziqi, LI Yang, TIAN Hua. Impact of robot assistance on restoration of limb length and offset distance in total hip arthroplasty. Chinese Journal of Reparative and Reconstructive Surgery, 2024, 38(11): 1307-1311. doi: 10.7507/1002-1892.202405034 Copy

1.	張亮, 李玉軍, 郭曉忠, 等. 人工全髖關節置換術治療髖關節感染繼發骨關節炎的中期療效. 中國修復重建外科雜志, 2014, 28(2): 218-222.
2.	Wylde V, Whitehouse SL, Taylor AH, et al. Prevalence and functional impact of patient-perceived leg length discrepancy after hip replacement. Int Orthop, 2009, 33(4): 905-909.
3.	Perets I, Walsh JP, Close MR, et al. Robot-assisted total hip arthroplasty: Clinical outcomes and complication rate. Int J Med Robot, 2018, 14(4): e1912. doi: 10.1002/rcs.1912.
4.	Flecher X, Ollivier M, Argenson JN. Lower limb length and offset in total hip arthroplasty. Orthop Traumatol Surg Res, 2016, 102(1 Suppl): S9-S20.
5.	Lecerf G, Fessy MH, Philippot R, et al. Femoral offset: anatomical concept, definition, assessment, implications for preoperative templating and hip arthroplasty. Orthop Traumatol Surg Res, 2009, 95(3): 210-219.
6.	Desai AS, Dramis A, Board TN. Leg length discrepancy after total hip arthroplasty: a review of literature. Curr Rev Musculoskelet Med, 2013, 6(4): 336-341.
7.	Kayani B, Pietrzak J, Donaldson MJ, et al. Treatment of limb length discrepancy following total hip arthroplasty. Br J Hosp Med (Lond), 2017, 78(11): 633-637.
8.	Nossa JM, Mu?oz JM, Riveros EA, et al. Leg length discrepancy after total hip arthroplasty: comparison of 3 intraoperative measurement methods. Hip Int, 2018, 28(3): 254-258.
9.	Kumar V, Patel S, Baburaj V, et al. Does robotic-assisted surgery improve outcomes of total hip arthroplasty compared to manual technique? A systematic review and meta-analysis. Postgrad Med J, 2023, 99(1171): 375-383.
10.	李楊, 王鑫光, 董子漾, 等. 機器人輔助技術對全髖關節置換術髖臼假體位置和下肢長度恢復的影響. 中華醫學雜志, 2022, 102(1): 43-48.
11.	Sai Sathikumar A, Jacob G, Thomas AB, et al. Acetabular cup positioning in primary routine total hip arthroplasty-a review of current concepts and technologies. Arthroplasty, 2023, 5(1): 59. doi: 10.1186/s42836-023-00213-3.
12.	Foissey C, Batailler C, Coulomb R, et al. Image-based robotic-assisted total hip arthroplasty through direct anterior approach allows a better orientation of the acetabular cup and a better restitution of the centre of rotation than a conventional procedure. Int Orthop, 2023, 47(3): 691-699.
13.	Zhang S, Liu Y, Yang M, et al. Robotic-assisted versus manual total hip arthroplasty in obese patients: a retrospective case-control study. J Orthop Surg Res, 2022, 17(1): 368. doi: 10.1186/s13018-022-03263-6.
14.	Domb BG, Chen JW, Lall AC, et al. Minimum 5-year outcomes of robotic-assisted primary total hip arthroplasty with a nested comparison against manual primary total hip arthroplasty: a propensity score-matched study. J Am Acad Orthop Surg, 2020, 28(20): 847-856.

1. 張亮, 李玉軍, 郭曉忠, 等. 人工全髖關節置換術治療髖關節感染繼發骨關節炎的中期療效. 中國修復重建外科雜志, 2014, 28(2): 218-222.
2. Wylde V, Whitehouse SL, Taylor AH, et al. Prevalence and functional impact of patient-perceived leg length discrepancy after hip replacement. Int Orthop, 2009, 33(4): 905-909.
3. Perets I, Walsh JP, Close MR, et al. Robot-assisted total hip arthroplasty: Clinical outcomes and complication rate. Int J Med Robot, 2018, 14(4): e1912. doi: 10.1002/rcs.1912.
4. Flecher X, Ollivier M, Argenson JN. Lower limb length and offset in total hip arthroplasty. Orthop Traumatol Surg Res, 2016, 102(1 Suppl): S9-S20.
5. Lecerf G, Fessy MH, Philippot R, et al. Femoral offset: anatomical concept, definition, assessment, implications for preoperative templating and hip arthroplasty. Orthop Traumatol Surg Res, 2009, 95(3): 210-219.
6. Desai AS, Dramis A, Board TN. Leg length discrepancy after total hip arthroplasty: a review of literature. Curr Rev Musculoskelet Med, 2013, 6(4): 336-341.
7. Kayani B, Pietrzak J, Donaldson MJ, et al. Treatment of limb length discrepancy following total hip arthroplasty. Br J Hosp Med (Lond), 2017, 78(11): 633-637.
8. Nossa JM, Mu?oz JM, Riveros EA, et al. Leg length discrepancy after total hip arthroplasty: comparison of 3 intraoperative measurement methods. Hip Int, 2018, 28(3): 254-258.
9. Kumar V, Patel S, Baburaj V, et al. Does robotic-assisted surgery improve outcomes of total hip arthroplasty compared to manual technique? A systematic review and meta-analysis. Postgrad Med J, 2023, 99(1171): 375-383.
10. 李楊, 王鑫光, 董子漾, 等. 機器人輔助技術對全髖關節置換術髖臼假體位置和下肢長度恢復的影響. 中華醫學雜志, 2022, 102(1): 43-48.
11. Sai Sathikumar A, Jacob G, Thomas AB, et al. Acetabular cup positioning in primary routine total hip arthroplasty-a review of current concepts and technologies. Arthroplasty, 2023, 5(1): 59. doi: 10.1186/s42836-023-00213-3.
12. Foissey C, Batailler C, Coulomb R, et al. Image-based robotic-assisted total hip arthroplasty through direct anterior approach allows a better orientation of the acetabular cup and a better restitution of the centre of rotation than a conventional procedure. Int Orthop, 2023, 47(3): 691-699.
13. Zhang S, Liu Y, Yang M, et al. Robotic-assisted versus manual total hip arthroplasty in obese patients: a retrospective case-control study. J Orthop Surg Res, 2022, 17(1): 368. doi: 10.1186/s13018-022-03263-6.
14. Domb BG, Chen JW, Lall AC, et al. Minimum 5-year outcomes of robotic-assisted primary total hip arthroplasty with a nested comparison against manual primary total hip arthroplasty: a propensity score-matched study. J Am Acad Orthop Surg, 2020, 28(20): 847-856.

Chinese Journal of Reparative and Reconstructive Surgery

Impact of robot assistance on restoration of limb length and offset distance in total hip arthroplasty

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