Robotic hip surgery: an expert’s guide

Hip replacements are a fairly common procedure as people get older. Wear and tear in the hip can mean that the only option is to replace the ball and socket joint with a prosthetic. Now, this procedure can be done with the assistance of robotic technology. Mr Winston Kim explains the advantages of robotic-assisted hip surgery.

Is robotic hip surgery the least invasive?

Robot-assisted hip surgery is about precision and accuracy when implanting a hip replacement. Hip replacement surgery is a technical operation. It requires precise implantation of the hip replacement socket and stem to ensure that the hip is stable and leg lengths are equal and to maximise the longevity of the hip replacement.

Surgeons are able to combine minimally invasive or optimally invasive hip replacement using robot-assisted technology. Minimally invasive techniques include a minimally invasive posterior approach to the hip or variations of the posterior approach or anterior approach to the hip. Ultimately, the approach utilised by surgeons does not matter as much as how well the hip components are implanted. Robot-assisted surgery reassures patients in relation to how well-positioned the implants are, based on the individual patients’ anatomies.

How does the MAKO robotic arm work?

Prior to surgery, the patient undergoes a CT scan where the precise anatomy of the hip is determined. The surgeon is then able to plan with the robot the precise and optimal placement of the hip replacement. At the time of surgery, pins are placed into the pelvis, which allows the robot to sense the patient’s hip. Registration sites or ‘points’ are then obtained during the surgery, which allows the robot to determine the optimal position of the hip implants. The robotic arm assists the surgeon in confirming accurate placement of implants before the surgeon finally inserts the hip implants into place.                                                             

What advantages does robotic hip surgery have over an arthroplasty/conventional hip replacement?

The advantages of robot-assisted hip surgery are the accurate and precise implantation of the prosthesis, thereby ensuring that the patient has hip replacement implants that are tailored to their individual anatomy, size and alignment. It reassures patients in terms of achieving equal leg lengths, a stable hip, and an increased potential of enhanced longevity of the hip implants.

Is robotic hip replacement better?

Robotic hip replacement is a procedure that uses relatively new technology. There is evidence that robotic arm-assisted hip replacement ensures more accurate and precise placement of the hip prosthesis. The experience so far is that it allows for very accurate placement of the hip replacement socket and ball for each individual patient and is reflected in reduced soft tissue trauma, less bone removed, increased likelihood of equal leg lengths, and a stable hip after surgery.

What about costs and recovery time?

For insured patients, the cost is the same as a conventional hip replacement. For self-pay patients, the additional costs are in the region of £1,000-£2,000 more than conventional hip replacement. The experience of surgeons utilising the technology is very positive thus far, with reduced time to full function and recovery but long-term clinical studies are required to confirm added benefits in terms of improved satisfaction, reduced leg length discrepancy and reduced complications relating to hip instability and enhanced longevity.

For more information or to book an appointment, visit Mr Kim’s Top Doctors profile.