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Review
. 2024 Apr;144(4):1843-1850.
doi: 10.1007/s00402-024-05230-8. Epub 2024 Feb 24.

Use of a fluoroscopy-based robotic-assisted total hip arthroplasty system produced greater improvements in patient-reported outcomes at one year compared to manual, fluoroscopic-assisted technique

Graham B J Buchan  1 , Christian B Ong  1 , Christian J Hecht Ii  1 , Charles A DeCook  2 , Luke S Spencer-Gardner  3 , Atul F Kamath  4
Affiliations
Review

Use of a fluoroscopy-based robotic-assisted total hip arthroplasty system produced greater improvements in patient-reported outcomes at one year compared to manual, fluoroscopic-assisted technique

Graham B J Buchan et al. Arch Orthop Trauma Surg. 2024 Apr.

Abstract

Introduction: The adoption of new technology should be supported by improvements in patient-reported outcomes (PROMs). The purpose of this study was to assess the one-year PROMs of patients who underwent total hip arthroplasty (THA) using a novel, fluoroscopy-based, robotic-assisted (RA-THA) system when compared to a manual, fluoroscopic-assisted technique (mTHA).

Materials and methods: A review of 91 consecutive mTHA and 85 consecutive RA-THA via a direct anterior approach was conducted. All cases were performed by the same surgeon at the same institution, for a pre-operative diagnosis of osteoarthritis, avascular necrosis, or rheumatoid arthritis. Outcomes included one-year Veterans RAND-12 (VR-12) Physical/Mental, Hip Disability and Osteoarthritis Outcome (HOOS) Pain/Physical Function/Joint Replacement, and University of California Los Angeles (UCLA) Activity scores, as well as the difference between pre-operative and one-year post-operative PROMs.

Results: Patients in the RA-THA cohort had lower pre-operative HOOS-JR scores compared to patients in the mTHA cohort (37.0 vs. 43.1; p = 0.031). Cohorts experienced similar one-year post-operative VR-12, HOOS, and UCLA Activity scores. Patients in the RA-THA cohort experienced greater improvements across all pre- and post-operative HOOS scores compared to patients in the mTHA cohort: Pain (+ 54.7 vs. +42.1; p = 0.009), Physical Function (-41.6 vs. -28.7; p = 0.007), and Joint Replacement (+ 46.6 vs. +33.0; p = 0.002). These differences exceeded minimum clinically important difference (MCID).

Conclusions: Both manual and robotic cohorts experienced benefit from THA at one-year post-operative. Importantly, the use of a novel, fluoroscopy-based robotic assistance system for primary THA resulted in greater improvements in PROMs at one-year relative to manual technique.

Keywords: Arthroplasty; Hip; Patient-reported outcome measures; Robotic-assisted surgery.

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Conflict of interest statement

• Authors G.B.J.B., C.B.O., C.J.H., and L.S.SG. declare that they have no relevant competing interests. Authors C.A.D. and A.F.K. have the below disclosures:

•C.A.D.

•Royalties: DePuySynthes, Mizuho-OSI.

•Speakers bureau: DePuySynthes, Medtronic.

•Stock or stock options: JointPoint, JointVue.

•A.F.K.

•Royalties: Innomed, ZimmerBiomet.

•Speakers bureau: ZimmerBiomet, Johnson and Johnson, BodyCad.

•Paid consultant: ZimmerBiomet, Johnson and Johnson, BodyCad, United Ortho, Orthopedic Development.

•Stock or stock options: ZimmerBiomet, Johnson and Johnson, Procter and Gamble.

•Research support: Signature Orthopedics.

Figures

Fig. 1
Fig. 1
An overview of the ROSA® Hip System. Deployment of this system includes the following steps: (1) Connecting the tablet to the robotic unit using Wi-Fi; (2) Selecting surgical parameters including planned cup angles, measurements, shell and stem type, impactor and C-arm diameter; (3) Installing the quick connect interface at the end of the robotic arm; (4) Draping the robotic arm and robotic unit; and (5) Calibrating the force sensor
Fig. 2
Fig. 2
An overview of the intra-operative navigation interface of the ROSA® Hip System. (Top) Screenshot of Cup Impaction panel. (Bottom) Screenshot of Cup Verification panel
See this image and copyright information in PMC

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