Robotic-Assisted Surgery Does Not Decrease Prosthetic Impingement in Total Hip Arthroplasty: A Retrieval Analysis

Description

This presentation from the ISTA 2024 conference held in Nashville provides a detailed transcription of a presentation discussing the factors contributing to total hip instability, specifically focusing on impingement between the femoral stem and acetabular cup in total hip arthroplasty. It describes the multifactorial nature of total hip impingement and highlights the influence of design factors such as head size and neck ratio in reducing periprosthetic impingement rates.



The presentation outlines the work conducted at the Hospital for Special Surgery, emphasizing their Institutional Review Board (IRB) approved lab's long-standing research on hip implant instability since 2005, which found significant rates of impingement in retrieved hip implants. Subsequent research from 2018 showed that larger head sizes and dual mobility cups could reduce, but not eliminate, impingement prevalence and severity.



The study's aim was to compare the prevalence and severity of acetabular liner impingements between robotic-assisted and non-robotic-assisted total hip arthroplasty. The findings reported a 61% impingement rate in robotic liners and 45% in the non-robotic group with no statistically significant differences between the two groups' impingement presence and severity. An important point raised was that although robotic assistance offers precise component positioning, mild impingement still occurs, suggesting the need to explore other factors such as soft tissue constraints in future research.



Overall, the findings underscore the necessity for larger cohort studies to fully understand the implications of robotic surgery on hip implant stability.

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