Robotic surgery
Robotic hip replacement
Total hip replacement with the active robotic system TSolution One®: 3D planning based on each patient’s anatomy and bone preparation with sub-millimetre accuracy, for a better implant fit and faster recovery.
- Sub-millimetre accuracy
- 95% implant–bone contact
- Walking a few hours later
What is total hip replacement
Total hip replacement is one of the most successful operations in modern orthopaedics. The worn parts of the joint, namely the head of the femur and the socket of the pelvis (acetabulum), are removed and replaced with artificial implants.
It is performed mainly to relieve the pain and stiffness caused by hip osteoarthritis, but also for fractures, hip dysplasia and other conditions of the joint.
When is hip replacement needed
The hip is a “ball-and-socket” joint: the head of the femur moves within the socket of the pelvis (acetabulum). The surfaces are covered with cartilage, which allows them to glide smoothly. When the cartilage wears away, the bones rub against each other, causing pain and restricted movement.
Initial treatment is usually conservative, with anti-inflammatory medication and physiotherapy. If symptoms persist, joint replacement should be considered, particularly when there is:
- Severe pain that does not ease with medication
- Pain that affects sleep or work
- Stiffness that makes walking difficult
- Difficulty sitting down and getting up from a chair
Read more about the condition: Hip osteoarthritis: symptoms, diagnosis and treatments →
How TSolution One® works in the hip
The system consists of TPLAN®, a 3D pre-operative planning workstation, and TCAT®, a robotic tool that carries out the surgeon’s plan.
- CT scanTPLAN® converts the CT scan of the hip into a 3D model of the femur and acetabulum.
- Personalised planningThe surgeon chooses the most suitable implant from an open library and positions it virtually to achieve the ideal fit and alignment.
- Robotic preparationTCAT® prepares the femoral canal and the acetabulum with sub-millimetre accuracy, exactly as defined in the plan.
During the operation, the surgeon uses a digitiser to register the exact position of the patient’s anatomy. If the bone moves even slightly, a monitoring system stops the robot immediately. After re-registration, the operation continues without any loss of accuracy.
Unlike semi-active systems, which simply guide the surgeon, TSolution One® is active: it carries out the bone preparation itself according to the plan, under the surgeon’s direct control. The system is cleared by the US FDA.
Clinical results
Studies on the long-term results of hip replacement show that a more accurate implant fit leads to better integration into the bone and less loss of bone density, thanks to better transfer of body weight.
Active robotic
Conventional technique
Data from a comparative clinical study of active robotic versus conventional hip replacement, as presented by the system’s manufacturer.
Advantages of robotic hip replacement
- Better integration of the implant into the bone
- Less loss of bone density
- Reduced leg length discrepancy after the operation
- Accuracy to tenths of a millimetre
- Precise alignment of the prosthesis
- Lower risk of intra-operative fracture
- Less blood loss
- Faster recovery
Types of hip replacement
- Total hip replacementThe most common operation. The socket (acetabulum) is replaced with a cup made of durable plastic (usually with a titanium metal shell), and the head of the femur with a ball made of ceramic or metal alloy, fixed to a metal stem inside the femur.
- Partial hip replacement (hemiarthroplasty)Only the head of the femur is replaced. It is usually performed in elderly patients with a hip fracture.
- Revision hip replacementReplacement of an older hip replacement that has worn out or loosened.
The operation can be performed through a posterior or an anterior approach, depending on the patient’s anatomy and needs. Both offer pain relief and improved walking from the very first hours.
The surgeon’s experience
Marios Salmas and his surgical team have been performing hip replacements since 1998, with very good results and minimal complications. Over the last decade they have used a navigation or robotic system to position the implants with maximum accuracy.
In a study of the team’s patients, 92% did not need their hip replacement replaced for 22 years.
Everything you need to know about total hip replacement
What to expect after the operation
- Day of surgeryPain is managed by the pain management team. Most patients get up and walk with a walking frame a few hours later.
- Day 1–2Walking unaided, climbing stairs with the help of a physiotherapist, and discharge. With the Fast-Track protocol, in suitable patients, discharge is possible even on the same day.
- 1–2 weeksPhysiotherapy at home and a gradual increase in walking distance.
- AfterwardsReturn to everyday activities and, gradually, to sport.
Robotic total hip replacement with a one-day hospital stay (Fast-Track)
Marios Salmas on robotic hip replacement on the TV programme “Ygeia pano ap’ ola” (Health above all)
The doctor will examine your case and recommend the right treatment.
Request an appointment210 7793103Frequently asked questions
Robotic hip replacement: frequently asked questions
Didn’t find the answer you were looking for? Call us on 210 7793103.
How long does the operation take?
Total hip replacement takes about an hour and a half, including preparation.
How many days will I stay in hospital?
Most patients stay one or two nights. With the Fast-Track protocol, some patients even go home on the same day.
When will I walk?
Mobilisation starts within the first few hours. Most patients walk unaided within one or two days.
Can both hips be replaced at the same time?
Yes. Healthy patients, usually under 75 and with no history of cardiorespiratory disease, can have both hips replaced in the same operation. In some cases it is preferable to have two separate operations.
What are the risks?
The operation is very safe, but like any surgical procedure it carries risks. The most serious is infection. Other risks include thrombosis in the leg or pelvis and dislocation of the hip. Your doctor will explain in detail how these are prevented.
What are the implants made of?
The prosthesis has three parts: the stem, made of titanium or cobalt-chromium, which is placed in the thigh bone (femur); the ball, made of ceramic or polished metal; and the cup, usually a plastic liner in a metal shell.
How long does a hip replacement last?
Generally 15–20 years and often longer, depending on the type of implant and the patient’s age and activity level. Among our team’s patients, 92% did not need revision surgery for 22 years.
Will I set off the metal detector at the airport?
Modern security scanners detect the implant, but the operator will recognise that it is a medical implant. It is a good idea to inform security staff before screening.
Patient cases
Patients after hip replacement
Robotic total hip replacement
Hip osteoarthritis — robotic hip replacement in an 89-year-old patient
Robotic replacement of both hips – 2 months later
Robotic replacement of both hips at the same time
Hip osteoarthritis — total hip replacement
Simultaneous hip and knee replacement — 20 days later
Patient testimonials
What our patients say
“What impressed me was the way he explained every detail to me about the joint, the operation and the recovery. I walked the same day. Most importantly, I now walk without the pain that had been tormenting me for the last few years.”
“On 6 October I had a hip replacement and on 7 October I was walking normally, something even I didn’t expect. A big thank you from the bottom of my heart to the doctor and all the staff at the clinic.”
“Professor Salmas is an excellent scientist, who explains very clearly the nature of the problem and the procedure of the operation.”
Appointment
Does your hip hurt?
Book an appointment for an assessment. The doctor will examine your case and explain whether robotic hip replacement is the right solution for you.