ROBOTIC HIP REPLACEMENT PERTH
Robot-Assisted Hip Replacement Surgery – A patient’s guide:
Dr Arash Taheri
MBBS (Hons), BMedSci (Hons), FRACS (Orth)
Orthopaedic Surgeon
Robot-Assisted Hip Replacement Surgery
What is Total Hip Replacement Surgery?
What is Total Hip Replacement Surgery? – Total Hip Replacement Surgery (also called Total Hip Arthroplasty) involves replacing a damaged or worn hip with an artificial hip joint called a prosthesis.
Hip replacement prothesis can be of metals such as stainless steel and titanium, ceramics, highly engineered polyethylenes and cements made of acrylic polymer.
A common hip replacement procedure takes 1-2 hours and may consist of:
- An incision over the front or side of the hip, through the layers of tissue
- Removal diseased and damaged bone and cartilage, leaving healthy bone intact
- Implantation of the prosthetic socket into your pelvic bone, to replace the damaged socket
- Replace the round ball on the top of the femur with the prosthetic ball, which is attached to a stem that fits into the thighbone.
Robot-Assisted Hip Replacement Surgery
What is MAKO Robot-Assisted Total Hip Replacement
MAKO Robot-Assisted Total Hip Replacement uses a Robotic Arm to precisely position the hip replacement components.
The state of the art technology minimises surgical error in prosthesis component positioning.
This helps with accurate leg length equality without the need to use an X-ray machine in theatre, reducing the risk of infection.
In the long-term, accurate component positioning facilitates less wear and prolongs the prosthetic components.
Compared to alternative techniques evidence shows that MAKO Robot-Assisted Total Hip Replacements:
- Are more Bone Conserving ie less bone is removed (better potential outcomes for future revision procedures).
- Results in a more ‘natural feeling hip’ as evidenced by the ‘Forgotten Hip Score’
- Has a lower hip dislocation rate post surgery
- Results in better functional outcome at 12 months post-surgery compared to other techniques.
What is the Best Total Hip Replacement Approach?
The are a number of surgical approaches that can be used in a Total Hip Replacement. The best one will depend on your particular circumstances and the outcome you desire from your surgery.
The decision regarding the most suitable total hip replacement approach best suited to you occurs after a detailed two-way consultation with you and Dr Taheri and a thorough analysis of:
- Your expectations of surgery
- Your bone anatomy (Bone – shape, size and density)
- Anticipated level and nature of post-surgical activities
- The underlying cause for you needing a Total Hip Replacement.
Dr Taheri will discuss the options available to you and give you all the information you need to help you make a decision.
How Long Will it Take to Recover from Robotic Hip Surgery?
Recovery times may vary from patient to patient for a number of reasons including age, current heath, muscle and bone strength and commitment to rehabilitation amongst many other factors.
Moving post surgery – Most patients may be able place some weight on the hip and walk with assistance (when safe to do so) 4-6 hours after surgery. Movement and slight weight bearing on your hip soon after surgery is encouraged.
Physiotherapy recovery program – You will see a physiotherapist and be prescribed a rehabilitation program after your surgery. Prior to discharge you will be given exercise instructions and practice on how to best perform daily activities including climbing stairs, getting into and out of cars etc.
Hospital stay length – Your hospital stay is usually 1-3 days. It may be longer depending on your individual circumstances.
Movement after surgery – Moving around with crutches is recommended for the first two weeks for comfort, safety and confidence. The crutches can be discarded as soon as you are confident to do so.
Will I need time off work – Depending on occupation you may require 2-6 weeks off work. You can be driven in a car as a passenger immediately on discharge from hospital.
Driving – Patients managed by anterior approach surgery can drive a car when they feel confident but no earlier than 2 weeks after their surgery (4 weeks for posterior approach surgery).
Patients MUST be able to perform an Emergency Stop and short car trips only are recommended initially. The decision to drive after surgery remains the responsibility of the patient.
Air travel – Air travel may be undertaken soon after you are cleared by your surgeon.
What Activities can I Return to After Rehabilitation?
What activities can you perform after a Total Hip Replacement – Once recovered and rehabilitated, there are very few restrictions on activity after a Total Hip Replacement. You can participate in activities such as walking, cycling, skiing and tennis.
Running and impact sports – High impact pursuits such as running cannot be performed for 6 months after surgery. Your suitability for returning to running activities depends on the nature and intensity of the sport you are undertaking and the type of prosthetic implant you have.
Some activities may place the joint replacement at risk (for example extremes of joint flexion and rotation in some advanced yoga postures) – if you are unsure please check with us prior to recommencing your desired activity.
Hip monitoring – Monitoring how your hip replacement performs overtime is essential to ensure it is functioning correctly. Follow up appointments will be scheduled in soon after surgery with a 1 year follow up and x-ray evaluation 5 years after the surgery.
What are the risks of a Total Hip Replacement?
Hip replacement risks – Hip replacement surgery is very safe, and serious complications are uncommon.
Here are some statistics on hip replacements:
- Serious wound infection occurs in less than 1% of patients.
- Dislocation occurs in less than 1% of people managed by direct anterior approach hip replacement (3% for posterior approach).
As with any major surgery, there are potential risks involved. The decision to proceed with the surgery is made because the advantages of surgery outweigh the potential disadvantages.
It is important that you are informed of these risks before the surgery takes place. Complications can be medical (general) or local complications specific to the hip. Medical complications include those of the anaesthetic and your general well being. Almost any medical condition can occur so this list is not complete.
Complications that may include:
- Allergic reactions to medications
- Blood loss requiring transfusion – Low risk of disease transmission
- Heart attacks, strokes, kidney failure, pneumonia and bladder infections
- Complications from nerve blocks such as infection or nerve damage
- Serious medical problems can lead to ongoing health concerns, prolonged hospitalisation or rarely death
Risk of Infection – Infection can occur with any operation. In the hip this can be superficial or deep. Infection rates are approximately 1 percent. If it occurs, it can be treated with antibiotics but may require further surgery. Very rarely your hip may need to be removed to eradicate the infection.
Blood Clots (Deep Venous Thrombosis) – These may travel to the lung (Pulmonary embolism) and can occasionally be serious and even life threatening. If you get pain or shortness of breath at any stage, you should notify your surgeon.
Wear and tear – The prosthetic eventually wears out over time, usually over 10 to 15 years, and may need to be changed.
Fractures or Breaks in the Bone – Fractures or breaks can occur during surgery or afterwards if you fall. To repair these, you may require surgery.
Wound Irritation or Breakdown – The operation will always cut some skin nerves, so you will inevitably have some numbness and potential aching around the wound. This will not affect the function of your joint. Vitamin E cream and massaging can help reduce this. Occasionally, you can get reactions to the sutures or a wound breakdown that may require antibiotics or rarely, further surgery.
Cosmetic Appearance – The knee may look different than it was because it is put into the correct alignment to allow proper function.
Leg length Inequality – Your leg will be restored to it’s original length as the deformity caused by wearing of the hip has been corrected.
Ligament Injuries – There are a number of ligaments surrounding the hip. These ligaments can be torn during surgery or break or stretch out any time afterwards. Surgery may be required to correct this problem. This problem is minimised with Robotic Assistance.
Damage to Nerves and Blood Vessels – Rarely these can be damaged at the time of surgery. If recognised they are repaired but a second operation may be required. Nerve damage can cause a loss of feeling or movement and can be permanent.
Discuss your concerns thoroughly with Dr Taheri prior to surgery.