Severe Hip Dysplasia Case Review: Robotics, Augments & Leg Length

In this episode of The Joint Replacement Podcast, I’m joined by Joshua Rozell to break down a challenging case of robotic total hip replacement in a patient with severe bilateral hip dysplasia and congenital dislocation.These are some of the most complex cases we treat in hip reconstruction, where anatomy is significantly altered and standard techniques may not apply. This discussion walks through both the preoperative planning and intraoperative decision-making required to safely and effectively restore hip function.We cover:• How to identify and reconstruct the true acetabulum in the setting of a pseudoacetabulum• Managing significant leg length discrepancy and setting appropriate patient expectations• When to consider a femoral shortening osteotomy to reduce tension on the sciatic nerve• Strategies to minimize the risk of sciatic nerve injury during hip lengthening• The role of robotic-assisted surgery in improving accuracy, visualization, and reproducibility• Indications for acetabular augments and how they provide both primary fixation and long-term stability• Step-by-step surgical workflow, including reaming, cup placement, augment positioning, and fixation techniques• Use of fluoroscopy and intraoperative landmarks to avoid common pitfalls• Implant selection decisions, including cemented vs cementless femoral components in complex anatomyWe also discuss how robotic planning allows surgeons to:→ Precisely locate the native hip center→ Optimize implant positioning and screw trajectories→ Anticipate bone defects and plan reconstruction strategies ahead of time→ Improve confidence when approaching highly abnormal anatomyOne of the most important themes in this case is patient communication. Restoring anatomy often requires intentional changes in leg length, and setting expectations preoperatively is critical to achieving a successful outcome.Whether you're a patient trying to understand complex hip replacement surgery, a trainee learning advanced reconstruction techniques, or a surgeon interested in the evolving role of robotics—this episode provides a detailed, practical look at modern approaches to complex hip dysplasia reconstruction.Follow for more episodes covering:Hip and knee replacement, robotic surgery, surgical decision-making, and patient education from one of the highest-volume robotic joint replacement surgeons in New England.#HipReplacement #Orthopedics #RoboticSurgery #HipDysplasia #JointReplacement #MedicalEducation