Australia Seeks The Help of A Robot In Hip Replacement

A hip replacement is a complicated procedure that involves an incision to expose the hip joint before the placement of an acetabular component and a femoral component. A head is then placed on the femoral component and a ball and socket joint is created. Sometimes, the acetabular component is called the cup while the femoral component is known as the stem. 

The procedure can be difficult to perform on certain patients, especially those with complex deformities resulting from childhood diseases, and those who are overweight.

Doctors have been performing hip replacement for years, and the process is thought to be a learning process for most doctors. Accurate positioning of all the components is crucial in any hip replacement procedure. Having the cup and stem in their required position reduces any future complications.

Hip replacement can cause future complications if performed poorly. One of the common complications is a dislocation, which is simply the head coming out of the cup. Ensuring the joint stem is located in a way that achieves optimal leg length means improved function of the hip.

Currently, surgeons rely on their judgment and experience when placing the components. However, previous studies have confirmed that even though surgeons may be experienced, they can still experience difficulty in placing the cup accurately. Sometimes, doctors face a huge challenge performing a hip replacement, and that is why robots had to be introduced.

Thanks to technology, robots came into the picture. However, their work is to constrain the surgeon while he or she remains in full control of the operation. The doctor carries the responsibility for the success of the operation or any complications that may arise from the process.

The use of robot technology to assist doctors in the procedure is not new in the United States but has only reached Australia recently.

The first robotically assisted hip replacement procedure in Australia was scheduled to be performed on April 20, 2016, on a patient at Brisbane’s Holy Spirit Northside Hospital. Reports indicate that more than 43,000 similar procedures were performed in 2015, in Australia alone, but they did not involve the use of robots.

Clearly, Australia has been lurking in the introduction of robots to facilitate hip replacement and up until recently, robotic orthopedic surgery was limited to partial knee replacements.

Performing hip replacement using robots involves the use of a controlled robotic arm called the MAKO robotic system. The arm helps the surgeon in placement of the components by making the procedure more safe and accurate, regardless of experience.

Traditionally, surgeons had to perform X-rays to plan a total hip replacement, but now, they only need a pre-operative CT scan to plan the entire operation.

Using a robot means the planning process is done by the surgeons in collaboration with specialist engineers. Both parties work together to establish the optimal component position before coming up with a plan. 

The plan facilitates the placement of the cup in the right position to be in line with patient’s anatomy while the stem is also placed to fit the femur of the patient. The goal is to restore the patient’s hip anatomy, mainly leg length.

During the procedure, the surgeon exposes the hip joint as usual then trackers are placed on the femur and the pelvis so that the robot can register the required information. A series of points on the patient’s femur and pelvis are then recorded by the robot, which creates a 3D representation matching the CT scan.

Once the robot has all the information, it is able to follow any movement made by the patient.

A cutting tool is attached to the robot and is used for preparing the bone to match with the cup. The surgeon holds the cutting tool, but he or she is constrained by the robot. At this point, the work of the robot is to restrict the surgeon’s movements so that he or she can only remove the required amount of bone.

The robot simply prevents any human error to ensure the cutting only occurs as planned. After the cutting, the robot grasps the cup and positions it correctly before the doctor hammers it into the right position in the pelvis.

Using a computer screen, doctors are able to monitor the position of the implant. The doctor then places a broach in the femur to prepare a cavity for the stem. The robot can then track the broach to ensure it is in its right position, and the patient’s leg is okay.

Most importantly, robotic surgeons do not have to achieve perfection. They just need to be better compared to human specialists.