Effectiveness of robotic technology for total hip replacement

Osteoarthritis is the aging and wear and tear of the joints. The degenerative disease, which affects three hundred million people in the world, is one of the main causes of disability and represents a cost to the state of 1% to 2% of GDP. But thanks to medical research and the contribution of new technologies to the medical service, there are effective treatments to find the most suitable solution for each patient.

Dr. Francisco del Canto, specialist in hip surgery originally from the Hospital Recoletas Salud Campo Grande, shared yesterday afternoon with the participants of the new edition of Aulas de la Salud, “Advances in Hip Osteoarthritis Surgery”. Organized by El Norte de Castilla and Grupo Recoletas, the informative talk took place as usual at the San Agustín Cultural Center in Valladolid.

The condition affects between 3.5% and 5.6% of the population over the age of 50, a percentage that reaches 10% in those over 80 and is more common in women. “The causes may be primary, that is, they appear suddenly without any previous history, or secondary, which are those derived from some disease which the hip has undergone.”

The doctor listed the most common symptoms, such as pain in the groin, in the lateral area of ​​the thigh, from the thigh to the knee, lameness and stiffness, which lead patients to come to the doctor’s office for a diagnosis based on the results of a physical examination. or radiological tests. «Usually, they are sufficient to diagnose a large part of the causes of coxarthrosis, but in some cases, which are more complex, the tests can be extended to magnetic resonance imaging (MRI) or computed axial tomography (CAT)» .

Treatments

Depending on the situation of each patient, there are several options for dealing with coxarthrosis, such as non-pharmacological, pharmacological treatment, infiltration and surgical treatment. First of all, Francisco del Canto pointed out that “it is recommended to lose weight, exercise, physiotherapy sessions and the possibility of using a cane or crutches”, in relation to the first option. In terms of pharmacology, he reviewed some of the drugs commonly used for any type of joint pain. Among them paracetamol and conventional anti-inflammatory drugs, COX-2 inhibitors and finally minor opioids. “It’s not a specific drug for hip pain, but it’s used for any joint pain depending on the symptoms,” he explained.

Infiltration

Other treatments are infiltrations with corticosteroids or hyaluronic acid or platelet-rich plasma. «This procedure requires a vision and guidance system, either radiological or ultrasound. The infiltration is done at the same time as an X-ray test or an ultrasound,” he noted. When previous options do not work, daily pain continues and daily life is limited, the doctor introduced surgical treatment, saying that “hip replacement is the best operation of the 20th century”, in reference to the title of an article published in the popular scientific medical journal ‘The Lancet’ in in 2007. “The reason is that this type of surgery increases the quality of life of patients along with cataract surgery,” he commented.

And in this sense, he continued his argument to emphasize that the results of the hip prosthesis implantation intervention are “excellent and there is a high level of satisfaction in terms of resuming usual activity, including sports”. It is an hour and a half operation with leg anesthesia and requires admission for two to three days. “The day after surgery you start walking on crutches,” he noted.

Regarding the materials used in the production of hip prostheses, surgeon Francisco del Canto talked about implants made of metal alloys such as titanium. “It consists of three components, the first is inside the femur, the second is placed in the patient’s pelvis, which is a cup, and then it has a ball, which is ceramic,” he indicated. Although usual fixation is not cemented, “in some cases, if the patient is elderly with osteoporosis or poor bone quality, cement fixation is used”.

He further mentioned post-procedure complications, which “are rare, occurring between 5% and 10%”, noting that they are usually due to dislocation of the prosthesis, infection, dysmetria or pain.

Operation with Mako

Finally, the hip surgeon presented the Mako robotic technology, which is used to implant total hip replacements, but also total knee replacements and partial or single chamber knee replacements. “The same system is used to perform three types of operations.”

The Recoletas de Campo Grande Hospital was a pioneer in the introduction of robotic surgery in 2022. «I have operated on more than two hundred cases. This type of technology that remains here represented a before and after in orthopedic prosthesis surgery. There are only 14 robots in Spain and Valladolid was one of the first cities to have this technology. It is a technology that has been in operation in the United States since 2010, with more than a million cases operated worldwide.

Del Canto insisted that “the robot is not a humanoid that operates on you, it is a tool that allows us to perform parts of the operation with much greater precision, because it allows millimeter adjustments that would not be possible to make with the eye.” Origen surgeon in Recoletas Campo Grande concluded: “Robotic surgery with Mako is more personalized, requires fewer complications and provides better results.”