{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T09:07:25Z","timestamp":1791709645857,"version":"4.3.4"},"reference-count":30,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Technology and Health Care"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Patient obesity is a risk factor for poor acetabular cup positioning in total hip arthroplasty (THA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>To assess the impact of using a novel, fluoroscopy-based robotic THA system on acetabular cup placement in obese versus non-obese patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      A review of 105 consecutive manual unassisted (mTHA) (47 Obese\/58 Non-obese) and 102 robotic-assisted (RA-THA) (50 Obese\/52 Non-obese) primary, direct anterior approach THA procedures was conducted. All cases were performed by a single surgeon, for a pre-operative diagnosis of osteoarthritis, avascular necrosis, or rheumatoid arthritis. Obesity was defined as a Body Mass Index (BMI)\n                      <jats:inline-formula>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" alttext=\"\\geqslant\" display=\"inline\" overflow=\"scroll\">\n                          <mml:mo>\u2a7e<\/mml:mo>\n                        <\/mml:math>\n                      <\/jats:inline-formula>\n                      30 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      . Outcomes included acetabular cup inclination and anteversion, and the proportion of cups within the Lewinnek safe-zone.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Obese patients in the mTHA cohort had larger cup inclination angles on average compared to non-obese patients (44.82\n                      <jats:sup>\u2218<\/jats:sup>\n                      <jats:inline-formula>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" alttext=\"\\pm\" display=\"inline\" overflow=\"scroll\">\n                          <mml:mo>\u00b1<\/mml:mo>\n                        <\/mml:math>\n                      <\/jats:inline-formula>\n                      6.51 vs. 41.39\n                      <jats:sup>\u2218<\/jats:sup>\n                      <jats:inline-formula>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" alttext=\"\\pm\" display=\"inline\" overflow=\"scroll\">\n                          <mml:mo>\u00b1<\/mml:mo>\n                        <\/mml:math>\n                      <\/jats:inline-formula>\n                      6.75;\n                      <jats:inline-formula>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" alttext=\"p=\" display=\"inline\" overflow=\"scroll\">\n                          <mml:mrow>\n                            <mml:mi>p<\/mml:mi>\n                            <mml:mo>=<\/mml:mo>\n                            <mml:mi\/>\n                          <\/mml:mrow>\n                        <\/mml:math>\n                      <\/jats:inline-formula>\n                      0.009). Obese mTHA patients were less likely to have cup placement within the Lewinnek zone compared to non-obese mTHA patients (0.48 vs. 0.67;\n                      <jats:inline-formula>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" alttext=\"p=\" display=\"inline\" overflow=\"scroll\">\n                          <mml:mrow>\n                            <mml:mi>p<\/mml:mi>\n                            <mml:mo>=<\/mml:mo>\n                            <mml:mi\/>\n                          <\/mml:mrow>\n                        <\/mml:math>\n                      <\/jats:inline-formula>\n                      0.027). Obesity had no effect on the accuracy of RA-THA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>Obesity affects the placement of the acetabular component in manual THA. The novel, fluoroscopy-based robotic THA system in this study demonstrated accurate cup placement regardless of obesity status.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3233\/thc-231127","type":"journal-article","created":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T11:27:46Z","timestamp":1699961266000},"page":"3703-3712","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Fluoroscopy-based robotic assistance for total hip arthroplasty improves acetabular cup placement accuracy for obese patients compared to the manual, fluoroscopic- assisted technique"],"prefix":"10.1177","volume":"32","author":[{"given":"Christian B.","family":"Ong","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Orthopaedic and Rheumatologic Institute, Cleveland Clinic Foundation, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham B.J.","family":"Buchan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Orthopaedic and Rheumatologic Institute, Cleveland Clinic Foundation, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian J.","family":"Hecht II","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Orthopaedic and Rheumatologic Institute, Cleveland Clinic Foundation, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel O.","family":"Kendoff","sequence":"additional","affiliation":[{"name":"Chefarzt Zentrum f\u00fcr Orthop\u00e4die und Unfallchirurgie, HELIOS Kliniken Berlin-Buch, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Homma","sequence":"additional","affiliation":[{"name":"Juntendo University Graduate School of Medicine","place":["Japan"]},{"name":"Juntendo University","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atul F.","family":"Kamath","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Orthopaedic and Rheumatologic Institute, Cleveland Clinic Foundation, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,9]]},"reference":[{"key":"e_1_3_3_2_2","first-page":"365","article-title":"Robotic-assisted total hip arthroplasty: Outcomes at minimum two-year follow-up","volume":"30","author":"Illgen RL","year":"2017","unstructured":"IllgenRLBukowskiBRAbiolaRAndersonPChughtaiMKhlopasA, et al. 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