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Resumen: Objetivos: Resultados clínicos, radiológicos y funcionales de la primera serie española de pacientes intervenidos de artroplastia total de cadera (ATC) asistida mediante brazo robótico Mako® (Stryker) del Hospital Clínico San Carlos (HCSC) de Madrid. Material y métodos: Estudio descriptivo prospectivo que analiza los primeros 25 pacientes intervenidos de ATC asistida por robot (ATCaR) en el HCSC, con un seguimiento mínimo de 4 meses. Se evaluaron la demografía, los estudios de imagen (procesamiento Mako®, Rx y TAC), los parámetros clínicos, la funcionalidad (Harris modificada) y las complicaciones asociadas. Resultados: La edad media fue 67,2 años (min 47, max 88), siendo el 56% varones. El 88% corresponden a coxartrosis primaria, el 4% postraumática, el 4% secundaria a NAV y el 4% secundaria a choque femoroacetabular.El tiempo medio de cirugía fue de 116,9 minutos (min 92, max 150). La media de las cinco primeras intervenciones fue 122,6 minutos, y la de las cinco últimas, de 108,2 minutos. Como complicaciones intraoperatorias se cuantificaron 4 pérdidas de marcadores intraoperatorios.El tiempo de ingreso medio fue 4,4 días (min 3, max 7), con una disminución de hemoglobina posquirúrgica media de 3,08 ± 1,08 g/dl, requiriendo transfusión en el 12% de los casos. Se registran tres complicaciones médicas durante el ingreso, destacando un síndrome confusional con caída y fractura periprotésica AG1 no desplazada.El análisis del posicionamiento de los implantes registrados con sistema Mako® fueron 40,55 ± 1,53 grados de inclinación y 12,2 ± 3,6 grados de anteversión acetabular. El estudio de imagen posquirúrgico realizado a los pacientes, en concordancia con Mako®, muestra valores de inclinación acetabular de 41,2 ± 1,7 en Rx y versión acetabular de 16 ± 4,6 en TAC.La discrepancia de longitud de cadera varía de valores preoperatorios de −3,91 mm (DE: 3,9; min −12, max 3) a 1,29 mm (DE: 1,96) tras la cirugía registrados con Mako®, con un aumento de longitud de cadera medio de 5,64 mm (DE: 3,35). El estudio Rx simple demuestra una diferencia posquirúrgica en concordancia con Mako® entre ambas caderas de 0,5 ± 3,08 mm.El offset femoral nativo se mantuvo tras la cirugía con una diferencia pre y posquirúrgica de la cadera intervenida de 0,1 mm (DE: 3,7), registrado con Mako®.La puntuación Harris modificada preoperatoria fue de 41,6 ± 13,3, mejorando hasta valores postoperatorios de 74,6 ± 9,7 a los 4 meses.No se registraron complicaciones en el postoperatorio inmediato (4 meses). Conclusiones: La artroplastia total de cadera asistida por brazo robótico consigue una adecuada exactitud y reproducibilidad en el posicionamiento de los implantes y la dismetría de cadera posquirúrgica, sin aumentar las complicaciones asociadas a la técnica. El tiempo de cirugía, las complicaciones y los resultados funcionales a corto plazo son comparables a la técnica convencional de las grandes series publicadas previamente. Abstract: Objectives: Clinical, radiological and functional results of the first Spanish series of patients undergoing total hip arthroplasty assisted by Mako® (Stryker) robotic arm at the Hospital Clínico San Carlos (HCSC) in Madrid. Material and methods: Prospective and descriptive study analyzing the first 25 patients who underwent robotic-assisted THA at the HCSC, with a minimum follow-up of 4 months. Demographics, imaging studies (Mako® processing, Rx and CT), clinical parameters, functionality (modified Harris) and associated complications were evaluated. Results: Average age was 67.2 years (min 47, max 88), being 56% male population sample. 88% involves primary coxarthrosis, 4% post-traumatic coxarthrosis, 4% secondary avascular necrosis and 4% secondary femoroacetabular impingement.Average surgery time was 116.9 min (min 92, max 150). The average time of the first five surgeries was 122.6 min, and, regarding the last five interventions, it was 108.2 min. Found medical intraoperative complications were four intraoperative markers loss.Average admission time was 4.4 days (min 3, max 7), with an average postoperative hemoglobin decrease of 3.08 ± 1.08 g/dL, requiring a transfusion in 12% of the cases. Three medical complications have been registered in the meantime of the admission, with a relevant case of a confusional syndrome and a fall, which resulted in a non-displaced AG1 periprosthetic fracture.The analysis of the positioning of registered implants with Mako® system shows 40.55 ± 1.53 acetabular inclination degrees and 12.2 ± 3.6 acetabular anteversion degrees. The postoperative image study carried out on patients, are consistent with Mako® s results, as it shows an acetabular inclination of 41.2 ± 1.7 in Rx, as well as acetabular anteversion of 16 ± 4.6 in CT.Hip length variance ranges depending on preoperative values of 3.91 mm (SD: 3.9; min −12, max 3) to 1.29 mm (SD: 1.96) after surgery registered with Mako®, with an increase of an average hip length of 5.64 mm (SD: 3.35). Rx simple study results show a postoperative difference between both hips of 0.5 ± 3.08 mm, which is consistent with Mako® results.Native femoral offset was stable after surgery with a showing difference both pre and post operative of the intervened hip of 0.1 mm (SD: 3.7), registered with Mako®.Preoperatory modified Harris punctuation was 41.6 ± 13.3, improving to postoperative values of 74.6 ± 9.7 after four months since the surgery. No complications were registered in immediate postoperative (4 month). Conclusions: Total hip arthroplasty robot-assisted achieves an adequate precision and repeatability of the implant positioning and the postoperative hip dysmetry without showing an increase of associated complications to the technique applied. Surgery time, complications and functional results in a short-time period are similar to conventional techniques applied to great series previously published.

Objectives: Clinical, radiological and functional results of the first Spanish series of patients undergoing total hip arthroplasty assisted by Mako® (Stryker) robotic arm at the Hospital Clínico San Carlos (HCSC) in Madrid., Material and Methods: Prospective and descriptive study analyzing the first 25 patients who underwent robotic-assisted THA at the HCSC, with a minimum follow-up of 4 months. Demographics, imaging studies (Mako® processing, Rx and CT), clinical parameters, functionality (modified Harris) and associated complications were evaluated., Results: Average age was 67.2 years (min 47, max 88), being 56% male population sample. 88% involves primary coxarthrosis, 4% post-traumatic coxarthrosis, 4% secondary avascular necrosis and 4% secondary femoroacetabular impingement. Average surgery time was 116.9min (min 92, max 150). The average time of the first five surgeries was 122.6min, and, regarding the last five interventions, it was 108.2min. Found medical intraoperative complications were four intraoperative markers loss. Average admission time was 4.4days (min 3, max 7), with an average postoperative haemoglobin decrease of 3.08±1.08g/dl, requiring a transfusion in 12% of the cases. Three medical complications have been registered in the meantime of the admission, with a relevant case of a confusional syndrome and a fall, which resulted in a non-displaced AG1 periprosthetic fracture. The analysis of the positioning of registered implants with Mako® system shows 40.55±1.53 acetabular inclination degrees and 12.2±3.6 acetabular anteversion degrees. The postoperative image study carried out on patients, are consistent with Mako® results, as it shows an acetabular inclination of 41.2±1.7 in Rx, as well as acetabular anteversion of 16±4.6 in CT. Hip length variance ranges depending on preoperative values of 3.91mm (SD: 3.9; min -12, max 3) to 1.29mm (SD: 1.96) after surgery registered with Mako®, with an increase of an average hip length of 5.64mm (SD: 3.35). Rx simple study results show a postoperative difference between both hips of 0.5±3.08mm, which is consistent with Mako® results. Native femoral offset was stable after surgery with a showing difference both pre and post operative of the intervened hip of 0.1mm (SD: 3.7), registered with Mako®. Preoperatory modified Harris punctuation was 41.6±13.3, improving to postoperative values of 74.6±9.7 after four months since the surgery. No complications were registered in immediate postoperative (4 months)., Conclusions: Total hip arthroplasty robot-assisted achieves an adequate precision and repeatability of the implant positioning and the postoperative hip dysmetry without showing an increase of associated complications to the technique applied. Surgery time, complications and functional results in a short-time period are similar to conventional techniques applied to great series previously published., (Copyright © 2023. Publicado por Elsevier España, S.L.U.)

Objectives: Clinical, radiological and functional results of the first Spanish series of patients undergoing total hip arthroplasty assisted by Mako® (Stryker) robotic arm at the Hospital Clínico San Carlos (HCSC) in Madrid., Material and Methods: Prospective and descriptive study analyzing the first 25 patients who underwent robotic-assisted THA at the HCSC, with a minimum follow-up of 4months. Demographics, imaging studies (Mako® processing, Rx and CT), clinical parameters, functionality (modified Harris) and associated complications were evaluated., Results: Average age was 67.2years (min 47, max 88), being 56% male population sample. 88% involves primary coxarthrosis, 4% post-traumatic coxarthrosis, 4% secondary avascular necrosis and 4% secondary femoroacetabular impingement. Average surgery time was 116.9min (min 92, max 150). The average time of the first five surgeries was 122.6min, and, regarding the last five interventions, it was 108.2min. Found medical intraoperative complications were four intraoperative markers loss. Average admission time was 4.4days (min 3, max 7), with an average postoperative hemoglobin decrease of 3.08±1.08g/dL, requiring a transfusion in 12% of the cases. Three medical complications have been registered in the meantime of the admission, with a relevant case of a confusional syndrome and a fall, which resulted in a non-displaced AG1 periprosthetic fracture. The analysis of the positioning of registered implants with Mako® system shows 40.55±1.53 acetabular inclination degrees and 12.2±3.6 acetabular anteversion degrees. The postoperative image study carried out on patients, are consistent with Mako® s results, as it shows an acetabular inclination of 41.2±1.7 in Rx, as well as acetabular anteversion of 16±4.6 in CT. Hip length variance ranges depending on preoperative values of 3.91mm (SD: 3.9; min -12, max 3) to 1.29mm (SD: 1.96) after surgery registered with Mako®, with an increase of an average hip length of 5.64mm (SD: 3.35). Rx simple study results show a postoperative difference between both hips of 0.5±3.08mm, which is consistent with Mako® results. Native femoral offset was stable after surgery with a showing difference both pre and post operative of the intervened hip of 0.1mm (SD: 3.7), registered with Mako®. Preoperatory modified Harris punctuation was 41.6±13.3, improving to postoperative values of 74.6±9.7 after four months since the surgery. No complications were registered in immediate postoperative (4month)., Conclusions: Total hip arthroplasty robot-assisted achieves an adequate precision and repeatability of the implant positioning and the postoperative hip dysmetry without showing an increase of associated complications to the technique applied. Surgery time, complications and functional results in a short-time period are similar to conventional techniques applied to great series previously published., (Copyright © 2023. Publicado por Elsevier España, S.L.U.)