title: Robotic-assisted femoral osteochondroplasty is more precise than a freehand technique in a Sawbone model.
abstract: Robotic-assistance has the potential to improve the accuracy of bony resections, when performing femoral osteochondroplasty in the treatment of cam-type femoroacetabular impingement (FAI). The purpose of this study was to determine the accuracy of robotic-assisted femoral osteochondroplasty and compare this to a conventional open, freehand technique. We hypothesized that robotic-assistance would increase the accuracy of femoral head-neck offset correction in cam FAI. Sixteen identical sawbones models with a cam-type impingement deformity were resected by a single surgeon, simulating an open femoral osteochondroplasty. Eight procedures were performed using an open freehand technique and eight were performed using robotic-assistance, through the creation of a three-dimensional haptic volume. A desired arc of resection of 117.7° was determined pre-operatively using an anatomic plan. Post-resection, all 16 sawbones were laser scanned to measure the arc of resection, volume of bone removed and depth of resection. For each sawbone, these measurements were compared with the pre-operatively planned desired resection, to determine the resection error. Freehand resection resulted in a mean arc of resection error of 42.0 ± 8.5° compared with robotic-assisted resection which had a mean arc of resection error of 1.2 ± 0.7° (P < 0.0001). Over-resection occurred with every freehand resection with a mean volume error of 758.3 ± 477.1 mm(3) compared with a mean robotic-assisted resection volume error of 31.3 ± 220.7 mm(3) (P < 0.01). This study has shown that robotic-assisted femoral osteochondroplasty in the treatment of cam-type FAI is more accurate than a conventional, freehand technique, which are currently in widespread use.
authors.affiliation: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY 10021 USA and MAKO Surgical Corp., Fort Lauderdale, FL 33317 USA.
authors.forename: Caroline N
authors.initials: CN
authors.lastname: Park
authors.affiliation: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY 10021 USA and MAKO Surgical Corp., Fort Lauderdale, FL 33317 USA.
authors.forename: Danyal H
authors.initials: DH
authors.lastname: Nawabi
authors.affiliation: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY 10021 USA and MAKO Surgical Corp., Fort Lauderdale, FL 33317 USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Christopher
authors.affiliation: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY 10021 USA and MAKO Surgical Corp., Fort Lauderdale, FL 33317 USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Conditt
authors.affiliation: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY 10021 USA and MAKO Surgical Corp., Fort Lauderdale, FL 33317 USA.
authors.forename: Anil S
authors.initials: AS
authors.lastname: Ranawat