Robotic Arm Assisted Total Hip Replacement Surgery

Drs Baird, Fassina and Munt were integral in introducing Mako Robotic Arm Assisted Joint Replacement Surgery to South Australia. This innovative and accurate option offers patient specific management of arthritic hip and knee conditions.
When using this technology to assist with a hip replacement procedure, it aids in the accurate positioning of the implants which has been shown to correlate with improved function and lifespan of the hip prosthesis. The procedure can be performed through all current surgical approaches to the hip (muscle sparring direct anterior, posterior and lateral).

what is a robotic arm assisted total hip replacement?

A Robotic Arm Assisted Total hip replacement is a minimally invasive and patient specific procedure for those suffering with painful hip arthritis. It is performed using the same surgeon controlled Robotic arm technology that Drs Fassina, Munt and Baird have been utilising for partial knee replacement surgery since December of 2015, and globally has assisted with over 100 000 robotic arm assisted hip and knee procedures.

This innovative surgical treatment now allows our surgeons to achieve consistently reproducible precision in hip and knee replacement surgery.

how does it work?

All people have unique anatomy (the way your bones, joints, muscle and soft tissues are made). Mako Robotic arm assisted surgery references your unique anatomy in order to plan and implement a patient specific hip replacement.

Patient Specific Planning:

Before surgery a CT scan is performed on your hip joint (pelvis and femur). The information obtained from this CT scan allows for a 3-Dimensional model of your hip joint to be created. This allows the surgeon to pre-operatively plan the size, orientation and centre of rotation of your acetabular cup and femoral stem.

Functional Implant Positioning:

During surgery, the software provides real time information to allow accurate implant position. The robotic arm can initially guide femoral neck resection and then assists with acetabular reaming and cup implantation. The system provides intra-operative confirmation of component version, predicted leg length and combined offset. These variables are all very important for decreasing the risk of dislocation, wear and post operative discomfort.

Robotic Arm Assisted Bone Preparation:

The surgeon controlled robotic arm provides tactile feedback, 3-D visualisation and auditory guidance to facilitate minimal bone removal while optimizing fixation of the components in an optimal position.

Patient-specific planning for femoral stem

Precision reaming of the acetabular cup

Surgical results summary

Finally once all components have been implanted, a summary screen allows your surgeon to confirm that your results are accurate and according to the pre-operative plan.

According to international research the robotic-assisted arm implantation results in a four to six times more accurate hip replacement surgery than a manually placed acetabular component.

the benefits

The Published Benefits of MakoPlasty THR are:

  • It allows for rapid return of function
  • It is a patient specific and minimally invasive solution for the treatment of hip arthritis.
  • It offers a new level of versatility, facilitating the surgical approach of choice: muscle sparing direct anterior, posterior or lateral.
  • It offers accurate cup placement compared with manual procedures, reducing potential for impingement, wear and dislocation.
  • Decreased risk of the implant and bone abnormally rubbing together (impingement) – this may improve the lifespan of your new hip.
  • It allows accurate leg length restoration, reducing potential for patient discomfort and walking difficulties
  • It Uses Components Which Perform Well on The Australian Joint Registry. The Stryker Trident acetabular component has a long track record of use in Australia and around the world with consistently good results. This can be coupled with different options for the femoral side including the Exeter stem which has over 40 years of clinical use.

who is a good candidate for a robotic arm assisted total hip replacement?

If you have one or more of the following symptoms, talk to your doctor as you are a candidate for MAKOplasty.
Pain while weight bearing on the affected joints.

  • Limping
  • Hip pain or stiffness
  • Difficulties with daily activities such as putting on socks and shoes; getting up from a low chair.
  • Pain at night

becoming a patient

We understand that undergoing any surgical procedure can be stressful and you may have may questions. The information in this document had been written to help you understand your condition better and what to expect before and after your surgery. During your consultation please ask any additional question you may have about the procedure or your recovery to you surgeon.

Nawabi DH, Conditt MA, Ranawat AS, Dunbar NJ, Jones J, Banks S, Padgett DE. Haptically guided robotic technology in total hip arthroplasty – A cadaveric Investigation. Proc Inst Mech Eng H. 2013 Mar;227(3):302-9.

Leg-Length Discrepancy After Total Hip Arthroplasty: Comparison of Robot-Assisted Posterior, Fluoroscopy-Guided Anterior, and Conventional Posterior Approaches. El Bitar YF, Stone JC, Jackson TJ, Lindner D, Stake CE, Domb BG. Am J Orthop (Belle Mead NJ). 2015 Jun;44(6):265-9.

Precision of robotic guided instrumentation for acetabular component positioning. Kanawade V, Dorr LD, Banks SA, Zhang Z, Wan Z. J Arthroplasty. 2015 Mar;30(3):392-7.

Precision of acetabular cup placement in robotic integrated total hip arthroplasty. Elson L, Dounchis J, Illgen R, Marchand RC, Padgett DE, Bragdon CR, Malchau H. Hip Int. 2015 Nov 25;25(6):531-6