Pune: Bilateral Robotic Hip replacement with Anterior approach gives relief to 32 year old with excruciating pain

Pune, 7th November 2023: A Bilateral Robotic Hip replacement with Anterior approach gave much relief to a 32 year old farmer from Dharashiv with excruciating pain in the hips. A team of doctors at Acrus Hospital in Wanowrie led by Dr. Rohit Luthra with this new front approach which is muscle sparing with minimal incisions and faster recovery .

Explaining the case Dr. Rohit Luthara, joint replacement and arthroscopy surgeon at Acrus Hospital said that the 32-year-old male patients hails had severe pain in both hips and is movements were affected and disabled. He could no longer work in fields. He came to us six weeks back. On carrying out diagnosis including blood tests, blood profile, fitness etc and taking his medical history to ensure that he had no prior surgeries or comorbidities, we came to a conclusion that he was a candidate for bilateral hip replacement surgery. Those who had prior surgeries or those with comorbidities are not candidates for this procedure.

Dr. Rohit Luthara added that the Anterior approach or the ‘Front’ approach as it is called is a minimally invasive and muscle sparing procedure. In this procedure the incision is made from the front instead of back or side. The damaged bones or cartilage are removed without detaching muscles or tendons and are just pushed aside instead of cutting to allow the implant to be placed. This results in minimal damage to the muscles and since the muscles are not cut, the patient can sooner bear his or her weight and start walking. Robotic system added pin point accuracy to the procedure including placing the implant into right position . It helps us in getting the exact offsets as per the patient’s native anatomy of the hip and there is minimal chance of implant malposition and the risk of dislocation is nearly zero .

One of the most crucial parts of robotic procedures is planning which ensure accuracy and safety for patients. The sizing of the implant is done with the CT scan before the operation. So we do a CT scan, we get a 3D virtual model of the hip and then we see what implant will best fit the patient and according to the anatomy the surgery is planned for the Robotic system to execute it to perfection. Also one very big advantage is that the limb length can be checked easily with this approach because the patient is lying supine ( flat on the back with face up) and not lying on side.

Dr. Luthara said that many a times hip replacement is done one at a time and there is a gap of 3-4 months considering the time for recovery. But in this case, taking the pain and the work profile of the patient, we decided to go with a Bilateral Robotic Hip replacement with Anterior approach. This technique will prove to be a game changer as significantly smaller incisions, minimal blood loss and minimal muscle loss will mean faster recovery time . In this case the procedure took around 3 hours .

The patient was made to stand within 4 hours of surgery and made to walk with a walker. Next day he was made to walk with a stick and now in six weeks he has recovered significantly and is getting back to his routine. This approach to hip replacement is a boon for patients.

The technique is relatively new and has been performed rarely in India, but this is the first case of Bilateral Hip replacement with Anterior approach using Robotics in India .