Robotic Hip Replacement FAQs
Do you have any conflict of interest for the implants that you use for your hip arthroplasties?
Can you use any implant with the robot?
Why do all hospitals not have the robotic system?
Additional considerations are if joint replacement surgeons at that hospital are interested in working with the technology. If a joint surgeon is interested, there is additional training that is needed to gain familiarity with the software before performing the procedure on patients.
Is there any additional out of pocket cost if I decided to have a robotic hip replacement?
Nevertheless, it is best to inquire with your hospital if the hospital charges more to do a robotic hip replacement than what is covered by your insurance. The hospital may decide to charge more for robotic hip replacement because they have to recover cost of equipment and there is additional work involved by the surgical team.
The robotic hip replacement does require more work for the surgeon and the assistants. There is preoperative planning involved in robotic hip replacement. Additional work is needed intraoperatively for placing pins into the pelvis for registration of the pelvis with the computer. the pins in the pelvis need to be removed after the surgery.
Additionally, the surgical wound at the pin site needs to be closed. Most of the additional work is intraoperatively, when the surgeon registers the pelvis for the robot to recognize the 3 dimensional geometry of the hip.
Is the surgery faster with a robot?
However, there are a few additional items that are done in a robotic hip replacement, like placement of the pins into the pelvis, removal of the pins and registration of the bony pelvis that take more time. Typically it takes more time to do robotic hip replacement surgery than a traditional hip replacement surgery.
What are the additional things that a surgeon has to do with a robotic hip replacement?
- Preoperatively, the surgeon has to plan the surgery from the CT scan that is performed on the patient.
- The surgeon has to look at logistics at the hospital if there are other surgeons using the robot for any surgery so that there is no conflict in operating time.
- The surgeon has to make incision in the pelvis and place pins for registering the anatomy of the pelvis with the robot and to match it with the preoperative CT scan.
- The surgeon has to do registration of the femur and the cup for the robot to recognize the 3 dimensional anatomy.
- After the surgical exposure is made, the surgeon has to place pins inside the pelvis and inside the femur for helping the robot understand that the hip geometry.
- EKG lead has to be placed over the knee before the surgery for helping the robot understand the limb length.
- The pins have to be removed at the end of the procedure.
- The markers from inside the hip need to be removed.
- The wound at the location of the pins in the pelvis has to closed after the pins are removed.
Is the incision smaller with robotic hip replacement?
Is the blood loss less after robotic hip replacement?
Will my hospital stay be less if I undergo a robotic hip replacement surgery?
Do you have a different rehabilitation protocol after robotic hip replacement surgery?
Do you perform robotic hip replacement surgery using an anterior or posterior approach?
Are there any disadvantages of using the robot?
The patient does require a CT scan before the procedure, which involves some radiation.
There is an additional risk in complication (although very low) because of placement of pins into the pelvis. The pins if placed incorrectly into the pelvis, can damage the structures inside the abdomen and inside the pelvis.
There is also the risk of breakage of pins that can cause retention of hardware or can necessitate additional exposure to remove the broken hardware (if the pin breaks).
The surgeon who is in training and is not very familiar with robotic hip replacement may have significantly increased time in the operating room and the patient can be exposed to increased risk of complications that are associated with increased surgical time.
If the surgeon is not cognizant of the anatomy and the location where components should be placed, the components can actually be placed in an incorrect position. In computer assisted navigation and robotics, I always say “garbage in and garbage out”. It is very important to give the robot accurate information.
If the information given to the robot is incorrect, then the robot and the computer will give incorrect information for placement of the implants. It is therefore critical to have a surgeon experienced not only in hip replacement surgery, but also in the working of the robot when choosing a robotic hip replacement surgery.
What happens if there is computer equipment malfunction intraoperatively? What happens if the robot crashes during the case?
What are biggest advantages that you see when you use a robot for hip replacement surgery?
Research has also shown there is a decrease in radiological outliers. As of 2018, one study has shown that this improved accuracy due to use of a robot improves patient outcomes in as less as 2 years. This is new technology and we are still gathering long term data.
Do you use different materials when you do robotic hip replacement surgery?
Do all hospitals have the equipment to perform a robotic hip replacement?
When you ask the surgeon this question, it would be good idea to inquire if the surgeon is employed by a hospital they operate out of (especially if the hospital does not have a robotic hip). Employed surgeons cannot operate at hospitals other than the hospital that employs them.
There are certain hospitals, which have the robotic equipment, but will not allow the surgeon to use the equipment procedures. As example, the hospital may have the robotic equipment, but may allow it to only for partial replacement of the knee and not necessarily to do hip replacement using robotic assistance.
Are robotic hip replacements better than traditional hip replacements?
Traditional hip replacement surgery has been shown to be very predictable in relieving pain from hip arthritis and in restoring range of motion of the hip. We have long-term results from traditional hip replacement surgery. Our hope is we can use technology like robotic hip replacement surgery to further improve the outcomes.
Does Medicare and commercial insurance cover robotic hip replacement?
Hip replacement is elective surgery and there should ideally be no surprises as to what your out of pocket expenses will be for the surgery. Patients are responsible for their deductible, copay and co-insurance. Some commercial insurance companies refuse to tell the provider what the amount of the patient’s deductible.
If a surgeon’s office is unable to tell you your out of pocket expense, you can call your insurance company to inquire about out of pocket costs. My experience with private insurance companies is that when the patient calls them and informs them, they are working with “out of network” provider, they try to steer the patient away to a doctor who is in their network. The majority of surgeons who provide excellent care in New York are not employed by hospitals and do not participate in most insurance networks.
If the patient has Medicare and a secondary insurance, the secondary insurance will cover the 20%. The patient may have a deductable with a secondary insurance. Medicare also has a deductible that is usually met within a few visits to the doctor in the early part of the year.
How long does it take to do robotic hip replacement surgery?
Are the indications different for robotic hip replacement versus a traditional hip replacement?
Is there any contraindication to do a robotic hip replacement?
What should I expect after a robotic hip replacement surgery?
Is the swelling more after a robotic hip replacement surgery because of the additional incision that is made in the pelvis?
The swelling after traditional hip replacement surgery in the affected extremity lasts for 4 to 6 weeks. I advise my patient to use compression stockings to control the swelling. Compression stockings also decrease the risk of blood clots after hip replacement.
Is the risk of blood clots more after a robotic hip replacement surgery?
Do you use any different blood thinner after the surgery after the robotic hip replacement surgery?
The advantage of aspirin is that it acts immediately. It is associated with less risk of bleeding inside the joint and elsewhere in the body. It is cheap and it also prevents the risks of heterotrophic ossification (which means formation of bone within the joint) that can lead to joint stiffness.
How long does the pain last after robotic hip replacement?
- Total Hip Replacement FAQs
- Total Knee Replacement FAQs
- Revision Knee Replacement FAQs
- Revision Hip Replacement FAQs
- Custom Knee Replacement FAQs
- Robotic Hip Replacement FAQs
- Arthritis FAQs
- Arthritis of the Knee FAQs
- Arthritis of the Hip FAQs
- Joint Replacement FAQs
- Computer Assisted Joint Replacement FAQs
- Joint Infection FAQs
- Hip Dislocation FAQs
- Hip Bursitis FAQs
- Avascular Necrosis FAQs
- Osteoporosis FAQs
- Bursitis FAQs
- Complications After Surgery FAQs
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