Domestic ROPA surgical robot for total hip arthroplasty: An artificial bone experiments_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

TAI Wenshuo ^1,2 ^{共同第一作者} , WEI Qingda ^1,2 ^{△共同第一作者} , DING Haoling ^1,2 ^{△共同第一作者} , LIU Xingyu ³ , ZHANG Yafang ¹ , GE Yi ¹ , WANG Guangzhi ³ ,  ZHANG Yiling ³ ,  CHAI Wei ¹

1. Department of Orthopedics, the Fourth Medical Center of Chinese PLA General Hospital, Beijing, 100048, P. R. China;
2. Chinese PLA Medical School, Beijing, 100039, P. R. China;
3. School of Biomedical Engineering, Tsinghua University, Beijing, 100084, P. R. China;

Corresponding?author：

ZHANG Yiling, Email: ylzhang@changmugu.com; CHAI Wei, Email: chaiwei301@163.com

Keywords：

Robot-assisted surgery; total hip arthroplasty; artificial bone experiment

DOI：

10.7507/1002-1892.202512081

Video：

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Objective To evaluate the effectiveness and precision of the domestic total hip arthroplasty (THA)-assisted robotic system ROPA through artificial bone experiments. Methods Robot-assisted THA was performed on 16 artificial bone models (8 left hips and 8 right hips) using the ROPA system. Preoperative CT scans were imported into the ROPA system for three-dimensional reconstruction and preoperative planning. Component size, acetabular cup position (anteversion and abduction angles), and osteotomy parameters (femoral neck osteotomy distance, offset, leg length discrepancy, and acetabular reaming bone volume) were recorded. Intraoperative probe verification accuracy, matching accuracy, remaining reaming distance, and remaining press-fit distance were documented. Postoperative three-dimensional scanning was performed to measure actual parameters, which were compared with planned values to calculate deviations. Results Osteotomy experiments were successfully completed on all 16 hip models. Component sizes were consistent with the preoperative plan in all 16 hip models. Deviations between actual and planned values were as follows: Anteversion angle was (0.79±1.69)° and abduction angle was (0.19±2.23)°. According to the initial position of acetabular cup, abduction angle was 40° and anteversion angle was 20°. The deviation of acetabular cup anteversion angle was (40.79±1.69)° and abduction angle was (20.19±2.23)°. All acetabular cups were implanted in the Lewinnek safe zone. The femoral neck osteotomy distance was (0.31±0.38) mm, the leg length discrepancy was (0.79±1.16) mm, the hip offset was (0.69±2.21) mm, and the acetabular fossa reaming bone volume was (0.03±0.06) mm, all of which met the acceptance criteria. The probe verification accuracy was (0.18±0.16) mm, the intraoperative registration accuracy was (0.50±0.22) mm, the remaining reaming distance was (?0.19±1.05) mm, and the remaining press-fit distance was (1.88±0.89) mm, all of which were in line with the expected design error range. Conclusion The domestic THA-assisted robotic system ROPA demonstrated favorable osteotomy accuracy, operational performance, effectiveness, and precision in artificial bone experiments. However, its long-term efficacy still requires further verification through clinical trials.

Citation： TAI Wenshuo, WEI Qingda, DING Haoling, LIU Xingyu, ZHANG Yafang, GE Yi, WANG Guangzhi, ZHANG Yiling, CHAI Wei. Domestic ROPA surgical robot for total hip arthroplasty: An artificial bone experiments. Chinese Journal of Reparative and Reconstructive Surgery, 2026, 40(7): 1047-1054. doi: 10.7507/1002-1892.202512081 Copy

1.	Ferguson RJ, Palmer AJ, Taylor A, et al. Hip replacement. Lancet, 2018, 392(10158): 1662-1671.
2.	Perets I, Mu BH, Mont MA, et al. Current topics in robotic-assisted total hip arthroplasty: a review. Hip Int, 2020, 30(2): 118-124.
3.	Gwam CU, Mistry JB, Mohamed NS, et al. Current epidemiology of revision total hip arthroplasty in the United States: National inpatient sample 2009 to 2013. J Arthroplasty, 2017, 32(7): 2088-2092.
4.	Bensa A, Pagliazzi G, Miele A, et al. Robotic-assisted total hip arthroplasty provides greater implant placement accuracy and lower complication rates, but not superior clinical results compared to the conventional manual approach: A systematic review and meta-analysis. J Arthroplasty, 2025, 40(7): 1921-1931.
5.	Ripollés-Melchor J, Abad-Motos A, Díez-Remesal Y, et al. Association between use of enhanced recovery after surgery protocol and postoperative complications in total hip and knee arthroplasty in the postoperative outcomes within enhanced recovery after surgery protocol in Elective Total Hip and Knee Arthroplasty Study (POWER2). JAMA Surg, 2020, 155(4): e196024. doi: 10.1001/jamasurg.2019.6024.
6.	Kayani B, Tahmassebi J, Ayuob A, et al. A prospective randomized controlled trial comparing the systemic inflammatory response in conventional jig-based total knee arthroplasty versus robotic-arm assisted total knee arthroplasty. Bone Joint J, 2021, 103-B(1): 113-122.
7.	Clement ND, Gaston P, Bell A, et al. Robotic arm-assisted versus manual total hip arthroplasty. Bone Joint Res, 2021, 10(1): 22-30.
8.	Gao Y, Yang Y, Li Z, et al. Systematic review of health economic evaluation of robot-assisted hip and knee arthroplasty. Health Econ Rev, 2025, 16(1): 7. doi: 10.1186/s13561-025-00701-z.
9.	柴偉. 關節外科機器人的現狀與思考. 中華骨與關節外科雜志, 2022, 15(8): 563-568.
10.	Banerjee S, Cherian JJ, Elmallah RK, et al. Robot-assisted total hip arthroplasty. Expert Rev Med Devices, 2016, 13(1): 47-56.
11.	Batailler C, Fernandez A, Swan J, et al. MAKO CT-based robotic arm-assisted system is a reliable procedure for total knee arthroplasty: a systematic review. Knee Surg Sports Traumatol Arthrosc, 2021, 29(11): 3585-3598.
12.	Kong X, Yang M, Jerabek S, et al. A retrospective study comparing a single surgeon's experience on manual versus robot-assisted total hip arthroplasty after the learning curve of the latter procedure—A cohort study. Int J Surg, 2020, 77: 174-180.
13.	Nawabi DH, Conditt MA, Ranawat AS, et al. Haptically guided robotic technology in total hip arthroplasty: a cadaveric investigation. Proc Inst Mech Eng H, 2013, 227(3): 302-309.
14.	Kamath AF, Durbhakula SM, Pickering T, et al. Improved accuracy and fewer outliers with a novel CT-free robotic THA system in matched-pair analysis with manual THA. J Robot Surg, 2022, 16(4): 905-913.
15.	Hayashi S, Hashimoto S, Kuroda Y, et al. Robotic-arm assisted THA can achieve precise cup positioning in developmental dysplasia of the hip: A case control study. Bone Joint Res, 2021, 10(10): 629-638.
16.	王文哲. 機器人輔助下全髖關節置換術早期療效研究. 青島: 青島大學, 2023.
17.	Geng X, Dong Z, Li Y, et al. Precise acetabular prosthesis positioning using a novel robot-assisted total hip arthroplasty system: A multicenter, randomized controlled trial. Orthop Surg, 2025, 17(1): 141-150.
18.	Schmitz PP, van Susante JLC, Hol A, et al. No decline in high patient satisfaction after total hip arthroplasty at long-term follow-up. Eur J Orthop Surg Traumatol, 2019, 29(1): 91-95.
19.	張卓, 孔祥朋, 楊敏之, 等. 機器人輔助人工全髖關節置換的短期療效分析. 骨科, 2020, 11(4): 269-273.
20.	Dretakis K, Koutserimpas C. Pitfalls with the MAKO robotic-arm-assisted total knee arthroplasty. Medicina (Kaunas), 2024, 60(2): 262. doi: 10.3390/medicina60020262.
21.	Pierce J, Needham K, Adams C, et al. Robotic-assisted total hip arthroplasty: an economic analysis. J Comp Eff Res, 2021, 10(16): 1225-1234.

1. Ferguson RJ, Palmer AJ, Taylor A, et al. Hip replacement. Lancet, 2018, 392(10158): 1662-1671.
2. Perets I, Mu BH, Mont MA, et al. Current topics in robotic-assisted total hip arthroplasty: a review. Hip Int, 2020, 30(2): 118-124.
3. Gwam CU, Mistry JB, Mohamed NS, et al. Current epidemiology of revision total hip arthroplasty in the United States: National inpatient sample 2009 to 2013. J Arthroplasty, 2017, 32(7): 2088-2092.
4. Bensa A, Pagliazzi G, Miele A, et al. Robotic-assisted total hip arthroplasty provides greater implant placement accuracy and lower complication rates, but not superior clinical results compared to the conventional manual approach: A systematic review and meta-analysis. J Arthroplasty, 2025, 40(7): 1921-1931.
5. Ripollés-Melchor J, Abad-Motos A, Díez-Remesal Y, et al. Association between use of enhanced recovery after surgery protocol and postoperative complications in total hip and knee arthroplasty in the postoperative outcomes within enhanced recovery after surgery protocol in Elective Total Hip and Knee Arthroplasty Study (POWER2). JAMA Surg, 2020, 155(4): e196024. doi: 10.1001/jamasurg.2019.6024.
6. Kayani B, Tahmassebi J, Ayuob A, et al. A prospective randomized controlled trial comparing the systemic inflammatory response in conventional jig-based total knee arthroplasty versus robotic-arm assisted total knee arthroplasty. Bone Joint J, 2021, 103-B(1): 113-122.
7. Clement ND, Gaston P, Bell A, et al. Robotic arm-assisted versus manual total hip arthroplasty. Bone Joint Res, 2021, 10(1): 22-30.
8. Gao Y, Yang Y, Li Z, et al. Systematic review of health economic evaluation of robot-assisted hip and knee arthroplasty. Health Econ Rev, 2025, 16(1): 7. doi: 10.1186/s13561-025-00701-z.
9. 柴偉. 關節外科機器人的現狀與思考. 中華骨與關節外科雜志, 2022, 15(8): 563-568.
10. Banerjee S, Cherian JJ, Elmallah RK, et al. Robot-assisted total hip arthroplasty. Expert Rev Med Devices, 2016, 13(1): 47-56.
11. Batailler C, Fernandez A, Swan J, et al. MAKO CT-based robotic arm-assisted system is a reliable procedure for total knee arthroplasty: a systematic review. Knee Surg Sports Traumatol Arthrosc, 2021, 29(11): 3585-3598.
12. Kong X, Yang M, Jerabek S, et al. A retrospective study comparing a single surgeon's experience on manual versus robot-assisted total hip arthroplasty after the learning curve of the latter procedure—A cohort study. Int J Surg, 2020, 77: 174-180.
13. Nawabi DH, Conditt MA, Ranawat AS, et al. Haptically guided robotic technology in total hip arthroplasty: a cadaveric investigation. Proc Inst Mech Eng H, 2013, 227(3): 302-309.
14. Kamath AF, Durbhakula SM, Pickering T, et al. Improved accuracy and fewer outliers with a novel CT-free robotic THA system in matched-pair analysis with manual THA. J Robot Surg, 2022, 16(4): 905-913.
15. Hayashi S, Hashimoto S, Kuroda Y, et al. Robotic-arm assisted THA can achieve precise cup positioning in developmental dysplasia of the hip: A case control study. Bone Joint Res, 2021, 10(10): 629-638.
16. 王文哲. 機器人輔助下全髖關節置換術早期療效研究. 青島: 青島大學, 2023.
17. Geng X, Dong Z, Li Y, et al. Precise acetabular prosthesis positioning using a novel robot-assisted total hip arthroplasty system: A multicenter, randomized controlled trial. Orthop Surg, 2025, 17(1): 141-150.
18. Schmitz PP, van Susante JLC, Hol A, et al. No decline in high patient satisfaction after total hip arthroplasty at long-term follow-up. Eur J Orthop Surg Traumatol, 2019, 29(1): 91-95.
19. 張卓, 孔祥朋, 楊敏之, 等. 機器人輔助人工全髖關節置換的短期療效分析. 骨科, 2020, 11(4): 269-273.
20. Dretakis K, Koutserimpas C. Pitfalls with the MAKO robotic-arm-assisted total knee arthroplasty. Medicina (Kaunas), 2024, 60(2): 262. doi: 10.3390/medicina60020262.
21. Pierce J, Needham K, Adams C, et al. Robotic-assisted total hip arthroplasty: an economic analysis. J Comp Eff Res, 2021, 10(16): 1225-1234.

Chinese Journal of Reparative and Reconstructive Surgery

Domestic ROPA surgical robot for total hip arthroplasty: An artificial bone experiments

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