ObjectiveTo investigate the efficacy of total hip arthroplasty (THA) assisted by the MAKO robotic arm via posterolateral approach.MethodsThe clinical data of 70 patients treated with THA via posterolateral approach between March 2017 and March 2019 who met the selection criteria were retrospectively analyzed. According to different treatment methods, the patients were divided into two groups, 35 were treated with MAKO robotic arm assisted THA (MAKO group) and 35 with traditional THA (THA group). There was no significant difference in gender, age, body mass index, disease duration, etiology, perioperative time, preoperative activity of daily living (ADL) scale index, American Society of Anesthesiologists (ASA) classification, walking ability, comorbidities, hemoglobin, and other general data between the two groups (P>0.05). The operation time, intraoperative blood loss, hospital stay, postoperative acetabular abduction and anteversion angles, postoperative length difference of bilateral lower limbs, and proportions of intraoperative blood transfusion, immediate postoperative loading, wound drainage time more than 2 days, and complications were recorded and compared between the two groups. According to the X-ray films at 6 months after operation, the reduction quality was judged. The forgotten joint score, Harris score, and proportions of independent walking and ADL index increased were used to evaluate the function recovery of patients.ResultsPatients in both groups were followed up 6-18 months, with an average of 8 months. There was no significant difference (P>0.05) between the two groups in operation time, intraoperative blood loss, hospital stay, acetabular abduction and anteversion angles, and length difference of both lower limbs at 6 months after operation. There was no significant difference in the proportions of intraoperative blood transfusion, immediate postoperative loading, and wound drainage time more than 2 days between the two group (P>0.05). X-ray reexamination at 6 months after operation showed that there was no significant difference in the reduction quality between the two groups (Z=4.191, P=0.123). Postoperative complications occurred in 7 patients (20.0%) in the MAKO group and 10 patients (28.6%) in the THA group, showing no significant difference in the incidence of complications between the two groups (χ2=2.121, P=0.224). Two patients (5.7%) in the MAKO group and 4 patients (11.4%) in the THA group underwent revision within 6 months, showing no significant difference in the revision rate between the two groups (χ2=0.729, P=0.673). At 3 and 6 months after operation, the proportions of independent walking and ADL index increased showed no significant difference between the two groups (P>0.05). Harris scores in both groups improved significantly when compared with preoperative scores (P<0.05); there was no significant difference in the forgotten joint scores and Harris scores between the two groups (P>0.05).ConclusionCompared with traditional THA, MAKO robotic arm assisted THA has longer operation time and more intraoperative blood loss, but it has the advantages of accurate positioning and simple operation, and there is no significant difference in short-term postoperative function recovery.
ObjectiveTo investigate the short-term effectiveness of MAKO robot assisted complex total hip arthroplasty (THA). Methods The clinical data of 15 patients (17 hips) underwent MAKO robot assisted complex THA between May 2020 and June 2021 were analyzed retrospectively. There were 5 males and 10 females with the age ranged from 19 to 70 years (median, 49 years), included 9 cases (9 hips) of developmental dysplasia of the hip (Crowe type Ⅱ in 5 hips, type Ⅲ in 1 hip, and type Ⅳ in 3 hips), 1 case (2 hips) of rheumatoid arthritis, 2 cases (3 hips) of ankylosing spondylitis, 3 cases (3 hips) of secondary arthritis with a history of acetabular fracture and internal fixation. The acetabular cup abduction angle and anteversion angle were measured at 3 months after operation, and compared with those measured by MAKO robot system before and immediately after operation. The femoral offset and leg length discrepancy (LLD) were measured at 3 months after operation, which were compared with those before operation. Harris hip score (HHS) and visual analogue scale (VAS) score were used to evaluate hip function before operation and at 3 months after operation. Results All 15 patients (17 hips) completed the operation successfully. The operation time was 75-175 minutes, with an average of 116.3 minutes; the intraoperative blood loss was 100-800 mL, with an average of 381.3 mL. Two patients were not included in the statistics because of intraoperative and postoperative complications, the remaining 13 patients (15 hips) had no serious complication such as vascular and nerve injuries, and 3 patients had intermuscular vein thrombosis. The 13 patients (15 hips) were followed up 3-15 months, with an average of 8 months. At last follow-up, the position of prosthesis did not change and there was no signs of loosening. There was no significant difference in acetabular abduction angle at immediate and 3 months after operation when compared with preoperative one (P>0.05), and the acetabular anteversion angle was significantly lower than that before operation (P<0.05). There was no significant difference in acetabular abduction angle and anteversion angle between at immediate and 3 months after operation (P>0.05). The LLD, offset, HHS score, and VAS score were significantly improved at 3 months after operation when compared with preoperative ones (P<0.05). Conclusion MAKO robot assisted complex THA can achieve good short-term effectiveness, improve the hip range of motion, reduce the length difference between bilateral lower limbs, and improve the quality of patients’ life.
Objective To investigate the effectiveness of MAKO robotic-arm assisted total hip arthroplasty (THA) via direct anterior approach (DAA) for bony fused hips in ankylosing spondylitis (AS). Methods Between June 2021 and January 2022, MAKO robotic-arm assisted THA via DAA was applied to treat 10 cases (12 hips) of AS with bony fused hips. There were 7 males and 3 females; the age ranged from 30 to 71 years, with an average age of 42.4 years. The duration of AS was 12-35 years, with an average of 21.4 years. The preoperative hip was ankylosed in flexion in 3 cases, with a flexion angle of 20°, 30°, 35°, respectively; 9 cases were ankylosed in extension. The operation time and complications were recorded; the visual analogue scale (VAS) score, Harris score, and Oxford hip scale (OHS) score before and after operation, and postoperative range of motion (flexion, extension, internal rotation, external rotation, adduction, and abduction) were used to evaluate the recovery of joint function; according to the postoperative anteroposterior X-ray film and CT scan of both hip joints, the abduction angle, anteversion angle, the difference between bilateral combined off-set and the lower limb length discrepancy were measured. Results The operation time ranged from 80 to 190 minutes (mean, 134.6 minutes). All 10 patients were followed up 5-11 months (mean, 7.4 months). There was no serious adverse events such as incision infection, deep vein thrombosis of lower extremities, hip redislocation, aseptic loosening of the prosthesis, or death. At 5 months after operation, the acetabular prosthesis angle of abduction was 37°-45° (mean, 40.3°), anteversion angle was 9°-20° (mean, 15.8°). The difference between bilateral combined off-set was 0-10 mm (mean, 4.3 mm); the lower limb length discrepancy was 0-12 mm (mean, 3.5 mm). At last follow-up, the average range of motion of the hip joint was 89.2° in flexion (range, 80°-100°), 1.7° in extension (range, –5°-10°), 7.1° in internal rotation (range, 0°-15°), 20.4° in external rotation (range, 10°-30°), 7.9° in adduction (range, 0°-20°), and 16.5° in abduction (range, 10°-25°). At last follow-up, the VAS score, Harris score, and OHS score significantly improved when compared with those before operation (P<0.05). ConclusionThe MAKO robotic-arm assisted THA via DAA can achieve satisfactory results in the treatment of AS with bony fused hip, which has the advantages of accurate prosthesis installation, soft tissue release, and less trauma during operation.