Abstract
Background
This study evaluated the accuracy of the cup alignment angles and spatial cup positioning
on computed tomography (CT) images in patients with osteoarthritis secondary to developmental
dysplasia of the hip (DDH) who underwent total hip arthroplasty (THA) using a minimally
invasive technique via an anterolateral approach in the supine position according
to whether a robotic arm-assisted system or a CT-based navigation system was used.
Methods
We reviewed 60 robotic arm-assisted (RA)-THA cases and 174 navigation-assisted (NA)-THA
cases. After propensity score matching, there were 52 hips in each group. Postoperative
cup alignment angles and position were assessed by superimposition of a three-dimensional
cup template onto the actual implanted cup using postoperative CT images with pelvic
coordinates matching the preoperative planning.
Results
The mean absolute error of the inclination angle and the anteversion angle between
the preoperative planning and the postoperative measurement was significantly smaller
in the RA-THA group (inclination, 1.1° ± 0.9; anteversion, 1.3° ± 1.0) than in the
NA-THA group (inclination, 2.2° ± 1.5; anteversion, 3.3° ± 2.5). For acetabular cup
positioning, the mean discrepancy between the preoperative planning and the postoperative
measurement was 1.3 ± 1.3 mm on the transverse axis, 2.0 ± 2.0 mm on the longitudinal
axis, and 1.3 ± 1.7 mm on the sagittal axis in the RA-THA group and 1.6 ± 1.4 mm,
2.6 ± 2.3 mm, and 1.8 ± 1.3 mm, respectively, in the NA-THA group. High precision
of cup positioning was observed in both groups with no statistically significant difference.
Conclusion
Robotic arm-assisted THA using a minimally invasive technique via an anterolateral
approach in the supine position allows accurate cup placement in patients with DDH.
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Article info
Publication history
Published online: February 15, 2023
Accepted:
January 31,
2023
Received in revised form:
December 2,
2022
Received:
September 14,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
