Robotic-Arm Assisted THA in Developmental Hip Dysplasia

This video was entered by Dr. Matthew Hepinstall in the 2022 KS International Robotic Surgery Innovation Awards, sponsored by the Vattikuti Foundation. It was featured in the Vattikuti Symposium ‘Humans at the Cutting Edge of Robotic Surgery,’ held in Miami, Florida November 19, 2022.

Here is the Abstract:

Title: Robotic-Arm Assisted THA in Developmental Hip Dysplasia

Background: Total hip arthroplasty (THA) for developmental dysplasia of the hip (DDH) is associated with higher rates of failure and revision compared to THA for primary osteoarthritis. Robotic-arm assisted THA includes pre-operative planning via 3D CT modeling, image-based navigation for surgical orientation and robotic-arm guidance for accurate and precise execution of the patient- specific surgical plan. Robotic-arm assistance may simplify these complex cases and enable more reliable and durable hip reconstruction.

Purpose: This video overview and case presentation demonstrates how to formulate a robotic based reconstructive plan and execute these objectives surgically for a patient with DDH.

Methods: Anatomic variations in DDH are reviewed. We discuss potential complications and how to decrease these risks via robotic technology. Literature exploring manual and robotic outcomes is summarized. We present the case of a 43 y.o. female with progressive left groin pain and lateral hip pain with a past medical history of bilateral DDH. The patient had previously undergone right-sided THA and elected to further proceed with a left-sided THA.

Results: The pre-operative plan was precisely achieved via robotic haptics. Post-operative clinical outcome showed improved range of motion, decreased limb length deficiency, and absence of a limp while ambulating.

Conclusion: Robotic THA for DDH has the potential to minimize failure and revision rates. Drawbacks include capital expenditures and the investment of time in learning a new technique, yet these complex cases benefit from meticulous pre-operative choices and confident intraoperative orientation.

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