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in Portugal (3/100 000 inhabitants). Figure 1 Annual total number of primary total hip arthroplasty (THA) implantations per 100 000 inhabitants in worldwide arthroplasty registers in collectives until 2012 and from 2012 to 2022. Table
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Introduction Over 3.1 million primary total hip arthroplasties (THA) have been performed in Europe since the mid-20th century. 1 Estimations based on current trends in the UK indicate a significant increase in primary THA, 2 with the
IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, Milan, Italy
Fondazione Livio Sciutto Onlus, Campus Savona - Università degli Studi di Genova, Via Magliotto 2, Savona, Italy
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IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, Milan, Italy
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Fondazione Livio Sciutto Onlus, Campus Savona - Università degli Studi di Genova, Via Magliotto 2, Savona, Italy
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The number of primary total hip arthroplasties (THAs) and revisions is expected to steadily grow in the future. The femoral revision surgery can be technically demanding whether severe bone defects need to be addressed.
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The femoral revision aims to obtain a proper primary stability of the stem with a more proximal fixation as possible. Several authors previously proposed classification systems to describe the morphology of the bony femoral defect and to drive accordingly the surgeon in the revision procedure.
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The previous classifications mainly considered cortical and medullary bone at the level of the defect of poor quality by definition. Therefore, the surgical strategies aimed to achieve a distal fixation bypassing the defect or to fill the defect with bone impaction grafting or structured bone grafts up to the replacement of the proximal femur with megaprosthesis.
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The consensus on a comprehensive and reliable classification system and management algorithm is still lacking. A new classification system should be developed taking into account the bone quality. The rationale of a new classification is that ‘functional’ residual bone stock could be present at the level of the defect. Therefore, it can be used to achieve a primary (mechanical) and secondary (biological) stability of the implants with a femoral fixation more proximal as possible.
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Background
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During the past decades, robotic-assisted technology has experienced an incredible advancement in the field of total joint arthroplasty (TJA), which demonstrated promise in improving the accuracy and precision of implantation and alignment in both primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, revision TJA remains a technically challenging procedure with issues of large-scale bone defects and damage to nearby anatomical structures. Thus, surgeons are trying to harness the abilities of robotic-assisted technology for revision TJA surgery.
Methods
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PubMed, Embase, Cochrane Library, and Google Scholar were comprehensively searched to identify relevant publications that reported the application of robotic-assisted technology in revision TJA.
Results
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Overall, ten studies reported the use of the robotic system in revision TJA, including active (ROBODOC) and semi-active (MAKO and NAVIO) systems. One clinical case reported conversion from hip fusion to THA, and three studies reported revision from primary THA to revision THA. Moreover, four studies reported that robotic-assisted technology is helpful in revising unicompartmental knee arthroplasty (UKA) to TKA, and two case reports converted primary TKA to revision TKA. In this study, we present the latest evolvements, applications, and technical obstacles of robotic-assisted technology in the revision of TJA and the current state-of-the-art.
Conclusion
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Current available evidence suggests that robotic-assisted technology may help surgeons to reproducibly perform preoperative plans and accurately achieve operative targets during revision TJA. However, concerns remain regarding preoperative metal artifacts, registration techniques, closed software platforms, further bone loss after implant removal, and whether robotic-assisted surgery will improve implant positioning and long-term survivorship.
Department of Orthopaedic Surgery, Vejle Hospital, Vejle, Denmark
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Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark
Orthopaedic Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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these variables have to be correct and in accordance with the clinical information on the patient and the surgical procedure. In 2004, the positive predictive value (PPV) of the registered primary diagnoses in patients undergoing primary total hip
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Introduction The short- and long-term success of primary total hip arthroplasty (THA) is associated with the correct reconstruction of the hip biomechanics. This includes the reconstruction of the rotation centre and offset, the correct
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Introduction Being the third most common cause of revision surgery following primary total hip arthroplasty (THA), peri-prosthetic joint infection (PJI) constitutes one of the most undesired complications, with a prevalence of 0.3% to 2
Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Buildings A & B, Thessaloniki, Greece
Trauma and Orthopaedics Department, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
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Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Buildings A & B, Thessaloniki, Greece
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Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Buildings A & B, Thessaloniki, Greece
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Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Buildings A & B, Thessaloniki, Greece
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Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Buildings A & B, Thessaloniki, Greece
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total knee replacements are expected in Sweden by 2030 ( 4 ). On the contrary, more lenient estimations projected an increase of primary total hip arthroplasty (THA) in the United States by 284% and primary total knee arthroplasty (TKA) by 401% in 2040
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published by Havelin et al. (2009). They assessed 280,201 primary total hip arthroplasty (THA) procedures performed in Sweden, Norway and Denmark from 1995 to 2006. Cemented THAs were used in 46% of patients in Denmark, in 89% of patients in Sweden and in 79
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total hip arthroplasty (THA) and 1–3% of primary total knee arthroplasty (TKA) are complicated by PJIs ( 7 ). Infection is cited as the indication for 14.7% of revision THAs and 25.2% of revision TKAs ( 8 ). The United Kingdom (UK) National Joint
