Precision in component placement:
The 3D planning and intraoperative guidance can assist with accurate positioning of the socket and stem, which is important for implant stability, range of motion, and long-term wear characteristics.
Leo Zalikha, MD performs robotic-assisted hip replacement in Long Beach, CA using the Mako robotic-arm system. He views robotic technology as one component of a broader commitment to precision, combining it with advanced training, detailed preoperative planning, and experience in adult reconstruction.
What Are the Potential Benefits?
When used by an experienced surgeon, robotic-assisted technology may offer advantages in certain aspects of hip replacement:
Patient-specific planning:
Every plan is built from a CT-based model of your individual anatomy, rather than relying solely on standard templates.
Leg length and offset management:
The system provides real-time data to help balance leg length and soft tissue tension during surgery.
Reproducibility:
Robotic guidance can help achieve consistent execution of the surgical plan from case to case.
It is important to be clear: robotic technology is a tool that supports surgical precision. It does not guarantee a specific outcome, eliminate all risks, or replace the importance of surgeon experience and judgment. Published evidence supports the role of robotic assistance in improving component positioning accuracy, but long-term outcome data is still being gathered.
How Robotic-Assisted Hip Replacement Works
Robotic-assisted hip replacement is not “robot surgery.” The surgeon performs every aspect of the procedure. The robotic system serves as a planning and guidance tool. Here is how the process works:
Before surgery, a CT scan of your hip and pelvis is obtained. This scan creates a detailed 3D model of your bone anatomy. Using this model, Dr. Zalikha plans the surgery in a virtual environment: selecting implant size, determining optimal position and orientation of each component, and mapping the surgical plan to your unique anatomy. This personalized, patient-specific plan is loaded into the robotic system before you enter the operating room.
During surgery, the robotic arm provides real-time feedback and guidance. As Dr. Zalikha prepares the bone and positions the implants, the system tracks the instruments in three-dimensional space and provides tactile boundaries to help execute the preoperative plan with a high degree of accuracy. The surgeon remains in full control at all times. The robotic arm does not move independently or make autonomous decisions. It functions as a precision-enhancing tool under the surgeon's direct guidance.
After component placement, the system allows Dr. Zalikha to verify implant position, leg length, and range of motion before completing the procedure. This additional layer of intraoperative data can help confirm that the surgical plan has been accurately executed.
Who is a Candidate?
Most patients who are candidates for total hip replacement can be considered for robotic-assisted surgery. The technology is particularly useful in cases where precise component positioning is especially important, such as patients with unusual anatomy, prior hip surgery, or specific implant requirements.
That said, robotic assistance is not required for every hip replacement. Some straightforward cases can be performed equally well without it. Dr. Zalikha uses robotic technology when it meaningfully adds to the surgical plan, not as a default marketing tool.
During your consultation, Dr. Zalikha will discuss whether robotic-assisted surgery is appropriate for your case and why.
Robotic-Assisted vs. Conventional Hip Replacement
Patients understandably want to know whether robotic surgery is “better.” Here is an honest comparison:
- Component positioning: Studies have shown that robotic-assisted surgery can improve the accuracy and consistency of implant placement compared to conventional techniques.
- Short-term outcomes: Some studies suggest improvements in early functional milestones and reduced pain scores with robotic-assisted surgery, though results vary.
- Long-term implant survival: There is not yet conclusive evidence that robotic-assisted hip replacement results in longer-lasting implants compared to well-performed conventional surgery. This data will continue to mature over time.
- Complications: Overall complication rates are similar between robotic-assisted and conventional hip replacement in the published literature.
The bottom line: robotic technology is a valuable precision tool, not a magic solution. The surgeon performing the procedure, their training, experience, and attention to detail, remain the most important factors in the outcome of your hip replacement.
The Mako Robotic-Arm System
Dr. Zalikha uses the Mako system (Stryker), one of the most widely adopted robotic platforms in orthopaedic surgery. The Mako system is cleared by the FDA for use in total hip replacement and has been used in hundreds of thousands of procedures worldwide.
The Mako system integrates CT-based 3D planning, real-time intraoperative navigation, and haptic (tactile feedback) guidance in a single platform. It is specifically designed for joint replacement applications.
Recovery After Robotic-Assisted Hip Replacement
The recovery timeline for robotic-assisted hip replacement is similar to that of conventional hip replacement. The use of robotic technology does not fundamentally change the recovery process, because the surgery itself (the approach, implant, and soft tissue management) is the primary driver of recovery.
When combined with the direct anterior approach, many patients are walking the same day as surgery and are candidates for outpatient (same-day) discharge.
For detailed recovery information, visit the Hip Replacement Recovery and Rehab page.
Risks and Considerations
Robotic-assisted hip replacement carries the same general risks as any hip replacement: infection, blood clots, dislocation, nerve or vessel injury, leg length discrepancy, fracture, and implant loosening or wear.
Additional considerations specific to robotic-assisted surgery:
- A preoperative CT scan is required, which involves a small amount of radiation exposure.
- The surgical setup may add a modest amount of time to the procedure.
- The technology is a tool; the quality of the outcome still depends on the surgeon's skill and decision-making.
These considerations are discussed during your preoperative visit.
Why Choose Dr. Zalikha for Robotic Hip Replacement
Dr. Zalikha completed his adult reconstruction fellowship at Stanford, where he trained in both conventional and robotic-assisted joint replacement techniques. He has authored over 30 peer-reviewed publications in orthopaedic surgery and arthroplasty, with research that has been cited hundreds of times. He uses the Mako robotic-arm system at MemorialCare Long Beach Medical Center and the Surgery Center of Long Beach.
His approach to robotic surgery is grounded in substance, not marketing: he uses the technology when it enhances precision and planning, and he is transparent about what it can and cannot do.