Exeter research aims to revolutionise hip surgery with robotic assistance

A cutting-edge study involving the University of Exeter has the potential to transform total hip replacement surgery.

The hip surgical techniques to enhance rehabilitation (HIPSTER) study, led by Exeter Hip Unit experts at the Royal Devon University Healthcare NHS Foundation Trust, aims to improve the experience of people undergoing total hip replacement surgery to treat severe arthritis.

Over 100,000 total hip replacements are performed each year in the UK. Traditionally, surgery has involved the posterior approach where surgeons cut through three tendons at the back of the hip joint to accurately position the artificial ball and socket. While the surgery is highly successful for most patients, over 10-percent still experience pain one year after the procedure and more than 6-percent express dissatisfaction with the results.

Alternative versions of this approach involve cutting fewer tendons, which may lead to quicker recovery, improved rehabilitation, and increased patient satisfaction. However, these changes can make positioning the socket more challenging.

The HIPSTER study investigates the impact of two innovative surgical techniques on patient outcomes, comparing them with the traditional approach. The study also incorporates the state-of-the-art MAKO robotic guidance system – technology that enables surgeons to have greater precision while retaining control, minimising tendon disruption.

Professor Tim Holsgrove from the University of Exeter is co-Chief Investigator of the HIPSTER study and said: “I’m delighted to be involved in this innovation, which continues a proud legacy of partnership between the University of Exeter and the Royal Devon University Healthcare NHS Foundation Trust. More than 50 years ago, this partnership produced a new type of implant known as the Exeter Hip, which has revolutionised surgery and improved lives for millions. We remain at the forefront of the field though the adoption of pioneering technologies such as robotic-guided surgery, and the development of novel surgical techniques, always with a focus on improving outcomes for patients.”

The study is jointly funded by a partnership between the National Institute for Health and Care Research (NIHR), and the Medical Research Council, and is delivered in collaboration with the department of engineering at the University of Exeter.

Gwyneth Marston, HIPSTER participant, said: “I was both proud and privileged to be asked to join the HIPSTER Study. I had a total hip replacement on 7 December last year and it was a fantastic success. The HIPSTER Team kept me fully informed throughout and closely monitored my progress and aftercare in order to make advancements to this type of surgery in the future. I was more than happy to share my progress with this pioneering team.”

Launched in October 2023 and managed by the Exeter Clinical Trials Unit (CTU), the study is open for recruitment until August 2025 and has already consented 245 participants.

Find out more about the HIPSTER study on the Royal Devon website: https://www.royaldevon.nhs.uk/about-us/research-and-development/take-part-in-a-research-study/