Possibilities of robot-assisted hip arthroplasty in dysplasia

Background. Acetabular dysplasia creates significant technical difficulties in total hip arthroplasty due to anatomical features and bone tissue deficiency for placement of endoprosthesis components. The use of robot-assisted technologies opens up new opportunities to improve the accuracy of surgical interventions in this pathology. Objective. To conduct a comparative assessment of the effectiveness of robot-assisted and traditional manual methods of total hip arthroplasty in patients with dysplastic coxarthrosis. Materials and methods. A prospective study of one hundred total hip arthroplasty operations for dysplastic coxarthrosis was conducted from 2023 to 2025. Patients were randomized into two groups of fifty people. The first group was operated on using the traditional manual method, the second - using the robot-assisted MAKO Robot system through a modified anterolateral approach according to Harding. All patients underwent a comprehensive preoperative examination, including pain assessment using the VAS scale, quality of life using the SF-36 questionnaire, and an X-ray examination to determine the degree of dysplasia according to the Crowe classification. Patients in the second group additionally underwent computed tomography using a special protocol for three-dimensional modeling. Control examinations were carried out three, six and twelve months after the operation. Results. The robot-assisted technique ensured the accuracy of positioning of the endoprosthesis components with a deviation of no more than one millimeter and one degree from the preoperative plan. The period of using crutches was reduced from three months with the manual technique to six weeks with the robot-assisted approach. The duration of hospitalization was reduced from six to three days. One year after the operation, the VAS score was zero in the robot-assisted hip replacement group versus two points in the manual method group. The quality of life according to the SF-36 questionnaire reached ninety-five points versus eighty points, respectively. No complications were registered in either group. Conclusion: Robot-assisted hip replacement for dysplasia demonstrates significant advantages over traditional methods, including high accuracy of component positioning, shorter rehabilitation period, and improved quality of life for patients. This technology can be considered as a method of choice for the treatment of dysplastic coxarthrosis with the prospect of widespread implementation in clinical practice.