The information on this website is not intended for diagnosis or treatment. Please consult your physician for health concerns.

+90 850 321 50 00

Navigation-Assisted Total Hip Arthroplasty (THA) — Advanced

Computer-assisted (CAS) and robotic-assisted (MAKO, ROSA Hip) total hip replacement using imageless or CT-based navigation to optimize cup inclination, anteversion, leg length, offset, and combined anteversion within Lewinnek-modified safe zones.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Ortopedi ve Travmatoloji department. Book Appointment →

What is Navigation-Assisted Total Hip Arthroplasty (THA) — Advanced?

Computer-assisted and robotic-assisted total hip arthroplasty (CAS-THA, RA-THA) employ navigation technology to enhance precision in implant positioning. Two main paradigms exist: (1) imageless infrared optical navigation (Brainlab, Stryker eOC) using anatomic landmarks and registration arrays, and (2) CT-based robotic platforms (MAKO Stryker, ROSA Hip Zimmer Biomet) that combine pre-operative 3D planning with intra-operative haptic-guided reaming and cup placement.

The technology addresses persistent challenges in THA—10–20% of cups are placed outside the Lewinnek 'safe zone' (inclination 30–50°, anteversion 5–25°), and modern data show spinopelvic mobility (Phan and Heckmann classifications), pelvic tilt, and combined femoral-acetabular anteversion all influence dislocation risk. Patients with prior lumbar fusion, ankylosing spondylitis, or fixed pelvis are at especially elevated risk and benefit from navigation. Functional safe zones now include sex-adjusted targets (combined anteversion 25–50°, sometimes higher in women) and dynamic spinopelvic considerations.

Robotic-assisted THA platforms enable pre-operative CT planning of cup size and position with respect to combined anteversion, femoral offset and leg length, then provide intra-operative haptic boundaries during reaming and impaction. RA-THA reduces inclination and anteversion outliers, improves leg-length restoration to within ± 5 mm in > 95% of cases, and may reduce 90-day revision rates for malposition or dislocation. Limitations include cost, additional operative time (10–20 min), reliance on accurate registration, and equivocal long-term PROM superiority over experienced freehand technique.

Symptoms

End-stage hip osteoarthritis with severe pain and functional limitation
Avascular necrosis of femoral head with collapse
Inflammatory arthritis (RA, ankylosing spondylitis) of hip
Post-traumatic arthritis after acetabular or femoral neck fracture
Failed prior hip surgery (hemiarthroplasty, resurfacing, conservative)
Severe deformity, dysplasia, Crowe IV high hip dislocation
Pre-existing spinal pathology (fusion, spondylitis) increasing dislocation risk

Risk Factors

Spinopelvic stiffness, prior lumbar fusion (Phan/Heckmann high-risk groups)
Posterior surgical approach (higher dislocation risk than anterior)
Crowe III–IV developmental dysplasia of hip
Severe femoral or acetabular bone loss (revision THA)
Obesity (BMI > 35), neuromuscular disease
Prior dislocation, recurrent instability
Female sex (slightly higher recommended cup anteversion)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent hip / groin pain unrelieved by conservative therapy
  • Limp, leg-length discrepancy, restricted hip motion
  • Difficulty putting on shoes, getting into car, climbing stairs
  • Failed prior hip surgery with persistent symptoms
  • Recurrent dislocation of prior hip implant
  • Severe deformity (dysplasia, post-traumatic, ankylosing spondylitis)
  • Need for complex reconstruction or revision THA

Treatment Methods

01
Pre-op planning: AP pelvis, lateral hip, and standing/sitting lateral spine X-ray (spinopelvic tilt assessment); CT pelvis-hip for robotic-assisted planning
02
Choose navigation platform: imageless infrared (Brainlab, Stryker eOC), electromagnetic, or CT-based robotic (MAKO Stryker, ROSA Hip Zimmer Biomet)
03
Determine functional cup target: standard Lewinnek (inclination 40 ± 10°, anteversion 15 ± 10°), modified for spinopelvic stiffness, dynamic targets via sit-stand pelvic tilt
04
Intra-operative: anatomic registration → 3D plan → robotic-arm haptic-guided reaming and impaction → trial reduction → final implant placement
05
Optimize: cup inclination 35–45°, cup anteversion 15–25°, combined anteversion 25–50° (sex-adjusted), leg-length discrepancy < 5 mm, femoral offset matched within ± 5 mm
06
Post-op: enhanced recovery (ERAS) protocol, day-0 mobilization, multimodal analgesia, DVT prophylaxis, abductor strengthening physiotherapy
07
Outcome assessment: HHS, OHS, SF-12, leg-length measurement, gait analysis, serial radiographs at 6 weeks, 6 months, 1 year, then annually for implant survivorship

Which Department to Visit?

You can visit our Ortopedi ve Travmatoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Ortopedi ve Travmatoloji Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

Book AppointmentContact Us

Related Health Topics

Other articles from the same department you may want to explore.

Low Back Pain and Lumbar Disc Herniation

Ortopedi ve Travmatoloji

Lumbar disc herniation occurs when the outer layer of the disc between the vertebrae tears and the inner part presses on nerve tissue, causing low back and leg pain.

Cervical Disc Herniation

Ortopedi ve Travmatoloji

Cervical disc herniation is a condition in which the disc between the vertebrae in the neck region presses on a nerve root or the spinal cord, causing neck, shoulder, and arm pain.

Knee Pain and Meniscus Tear

Ortopedi ve Travmatoloji

Meniscus tear is a tearing of the cartilage structures in the knee joint as a result of a sudden twisting movement or degeneration and is one of the most common causes of knee pain.

Shoulder Pain and Frozen Shoulder

Ortopedi ve Travmatoloji

Frozen shoulder (adhesive capsulitis) is a chronic condition characterized by inflammation and thickening of the shoulder joint capsule, causing restriction of movement in all directions and severe pain.

Bone Fractures

Ortopedi ve Travmatoloji

A fracture is partial or complete disruption of the integrity of bone tissue due to an external force or bone disease, and it can occur at any age.

Wrist Fracture (Distal Radius Fracture)

Ortopedi ve Travmatoloji

Distal radius fracture is one of the most common reasons for emergency room visits; it occurs when the radius bone fractures at the wrist end due to the hand being planted on the ground during a fall.

Hip Fracture

Ortopedi ve Travmatoloji

Hip fracture is a serious fracture mostly occurring in elderly individuals with osteoporosis due to a fall in the femoral neck or trochanteric region, and early surgical treatment is life-saving.

Ankle Sprain

Ortopedi ve Travmatoloji

Ankle sprain is a partial or complete tear of the ankle ligaments, most commonly involving the lateral ligament complex (ATFL, CFL, PTFL) after an inversion injury.

Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.