%0 Journal Article
%T Cement Removal from the Femur Using the ROBODOC System in Revision Total Hip Arthroplasty
%A Mitsuyoshi Yamamura
%A Nobuo Nakamura
%A Hidenobu Miki
%A Takashi Nishii
%A Nobuhiko Sugano
%J Advances in Orthopedics
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/347358
%X Introduction. The perforation and fracture of the femur during the removal of bone cement in revision total hip arthroplasty (THA) are serious complications. The ROBODOC system has been designed to selectively remove bone cement from the femoral canal, but results have not been reported yet. The purpose of our study was to evaluate the clinical and radiographic results of revision THA using the ROBODOC system for cement removal. Materials and Methods. The subjects comprised 19 patients who underwent revision THA using the ROBODOC system. The minimum duration of follow-up was 76 months (median, 109 months; range, 76¨C150 months). The extent of remaining bone cement on postoperative radiography, timing of weight bearing, and the complications were evaluated. Results. The mean Merle dĄŻAubigne and Postel score increased from 10 points preoperatively to 14 points by final follow-up. Bone cement was completely removed in all cases. Full weight bearing was possible within 1 week after surgery in 9 of the 19 cases and within 2 months in all remaining cases. No instances of perforation or fracture of the femur were encountered. Conclusions. Bone cement could be safely removed using the ROBODOC system, and no serious complications occurred. Full weight bearing was achieved early in the postoperative course because of circumferential preservation of the femoral cortex. 1. Introduction The perforation and fracture of the femur during the removal of bone cement in revision total hip arthroplasty (THA) are serious complications that considerably affect the postoperative protocols and clinical results [1]. With the increasing frequency of revision THA, the incidence of intraoperative femoral fracture has increased recently [2, 3]. To prevent the perforation and fracture of the femur, several instruments and procedures have been developed especially for bone cement removal. However, sufficient results have not been achieved yet in the clinical setting [4¨C7]. Extended trochanteric osteotomy was introduced for difficult situations in revision THA [8¨C11], but good results have not necessarily been obtained with the procedure in terms of intraoperative femoral fracture [8, 10, 12]. Since 1992, a computer-assisted surgical system called ROBODOC (Integrated Surgical Systems, Davis, CA) has been used in clinical settings and is highly regarded for the accuracy of the surgical process [13¨C15]. After making system improvements, the ROBODOC system received 510(k) clearance from the US Food and Drug Administration in 2008. Using ROBODOC, the rate of intraoperative femoral fissures
%U http://www.hindawi.com/journals/aorth/2013/347358/