Use of a Robotic Platform Compared with Manual Preparation for Revision Total Hip Arthroplasty: A Cadaver-Based Feasibility Study.

INTRODUCTION: Aim and Background: Revision total hip arthroplasty (THA) is technically demanding, particularly when acetabular bone loss, distorted anatomy, and uncertain screw fixation complicate reconstruction. Robotic-assisted platforms may improve pre-operative planning and intraoperative execution, but its role in revision THA has not yet been fully established. This cadaver-based feasibility study evaluated the effectiveness of robotic-assisted technology in revision THA acetabular reconstruction. MATERIALS AND METHODS: In one fresh-frozen specimen with prior bilateral manually performed total hip arthroplasties, full acetabular revision with standardized acetabular defects was performed. Computed tomography-based robotic-assisted revision THA was performed on one side and conventional manual revision THA on the contralateral side. Pre-operative planning, acetabular preparation, component positioning, screw number and length, quadrant distribution of screw fixation, pelvic perforation, and augment preparation were assessed. RESULTS: Robotic-assisted revision THA achieved fixation in all four acetabular quadrants using screws ranging from 20 mm to 40 mm, without pelvic perforation. The final construct closely matched the pre-operative plan, with 1.2° absolute inclination error, and augment preparation and implantation required <5 min. Manual revision THA achieved fixation across three acetabular quadrants using six screws ranging from 15 to 40 mm; however, all demonstrated pelvic perforation. Manual preparation showed greater intraoperative variability, and augment preparation and implantation required approximately 15 min. CONCLUSION: Robotic-assisted revision THA demonstrated greater concordance with pre-operative planning, broader acetabular screw fixation, avoidance of pelvic perforation, and faster augment preparation compared with manual techniques. These findings suggest robotic-assisted technology may enhance precision and reproducibility in complex revision THA and warrant further clinical investigation.