Use of robotic technology in cam femoroacetabular impingement corrective surgery

Int J Med Robot. 2013 Mar;9(1):23-8. doi: 10.1002/rcs.1486. Epub 2013 Feb 6.

Abstract

Background: Cam type femoroacetabular impingement (FAI) is an anatomical disorder that can lead to osteoarthritis (OA) of the hip joint. With existing surgical options there is invariably a tendency for under-resection or over-resection of the cam lesion, both having dire consequences. This study assessed the application of robotic technology in the surgical management of cam FAI.

Methods: Three different dry-bone femur models (14 in each) with severe cam deformity underwent corrective surgery using a haptic robot with active constraints. The 'post surgery', models were CT scanned and 3-D alpha angles and head/neck ratios (HNRs) were compared with pre-operative plans.

Results: In all models, the robotic resection resulted in a measured reduction of the maximum alpha angle to an angle indicative of no clinical impingement (first model 91° vs 49° ± 3°, second 91° vs 55° ± 5°, and third 87° vs 47° ± 2° P < 0.001). Similarly, the HNRs for all models reduced substantially following resection surgery.

Conclusions: This dry bone study validates the use of robotic technology to perform cam FAI corrective surgery. A more accurate bony resection may minimize complications due to over- and under-resection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Femoracetabular Impingement / diagnostic imaging*
  • Femoracetabular Impingement / surgery*
  • Femur Neck / diagnostic imaging*
  • Femur Neck / surgery*
  • Humans
  • Imaging, Three-Dimensional / methods
  • Plastic Surgery Procedures / methods
  • Radiography
  • Reproducibility of Results
  • Robotics / methods*
  • Sensitivity and Specificity
  • Surgery, Computer-Assisted / methods*