Hapto-robotic Assisted Total Hip Replacement for Hip Near Ankylosis

Objective: Robotic-assisted total hip surgery is most used for primary total joint surgery to remove outliers in cup positioning that affect motion and stability. However, they may also have value in difficult primary total hips. In this case report, this method was used for a patient with severe pseudoarthrosis. Materials and Methods: The posterior approach was planned for the patient. Preoperative CT scan was obtained in preparation for the hapto-robotic MAKOplasty system (Stryker). Results: The preoperative 2 cm leg length difference was reduced to 8 mm based on the MAKOplasty display. The patient’s range of motion was improved compared with baseline with flexion of 80 degrees, 10 degrees of internal rotation, 30 degrees of external rotation, and full extension without undue tightening. Conclusion: Total hip replacement in the setting of pseudoarthrosis represents a complex primary procedure that can improve range of motion and pain relief. The use of the CT-based hapto-robotic assisted procedure (ie, MAKOplasty) allowed the desired placement of the acetabular implant and assessment of leg length discrepancy but was only possible through the use of the described technique for true acetabular identification used in this case.