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Comparative Study
. 2024 Sep;34(5):569-577.
doi: 10.1177/11207000241264256. Epub 2024 Aug 8.

Postoperative outcomes and trends in computer-navigated and robotic-assisted total hip arthroplasty

Amit S Piple  1 , Jennifer C Wang  1 , William Hill  1 , Matthew S Chen  1 , Brandon S Gettleman  2 , Kevin C Liu  1 , Nathanael D Heckmann  1 , Alexander B Christ  1
Affiliations
Comparative Study

Postoperative outcomes and trends in computer-navigated and robotic-assisted total hip arthroplasty

Amit S Piple et al. Hip Int. 2024 Sep.

Abstract

Introduction: As the volume of technology-assisted total hip arthroplasty (THA) increases, there is a need to characterise the outcomes of robotic-assisted (RA) and computer-navigated (CN) THA. The goal of this study was to assess outcomes and opioid consumption following CN-THA and RA-THA compared to conventionally-instrumented (CON) THA.

Methods: The Premier Database was queried for all patients who underwent primary, elective THA from 2015-2020. Patients were divided into 3 groups: CN, RA, or CON-THA. Yearly usage trends were assessed. Univariate and multivariate analyses were performed to assess the 90-day risk of postoperative complications. Opioid consumption was reported in morphine milligram equivalents (MME) for postoperative days (POD) 0 and 1.

Results: Overall, 474,707 elective THAs were identified (95.7% CON, 2.1% CN, 2.2% RA. After accounting for confounders, CN-THA patients were at decreased risk for periprosthetic joint infection (PJI) (aOR: 0.55, p < 0.001) and dislocation (aOR 0.45, p < 0.001), but increased risk for blood transfusion (aOR 1.97, <0.001) compared to CON-THA. RA-THA patients were at decreased risk of dislocation (aOR:0.66, p < 0.001) but increased risk for transfusion (aOR 1.20, p < 0.001), prosthesis breakage (aOR 3.88, p < 0.001), and periprosthetic fracture (aOR 1.72, p < 0.001). Opioid consumption for CN-THA patients was lower on POD1 and lower for RA-THA patients POD0 and 2 compared to CON-THA.

Discussion: CN-THA was associated with reduced rates of PJI and dislocation, but increased rates of blood transfusion while RA-THA was associated with decreased rates of dislocation, but increased rates of blood transfusion, prosthesis complications, and periprosthetic fracture compared to CON-THA. Technology-assisted THA was associated with lower postoperative opioid consumption.

Keywords: Complications; computer navigation; opioids; robotic assistance; total hip arthroplasty; trends.

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Conflict of interest statement

Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: NDH: Royalties from Corin U.S.A.; Paid consultant for Intellijoint Surgical, MicroPort Orthopedics, Corin U.S.A, Zimmer; Stock or stock options in Intellijoint Surgical.ABC: Paid consultant for Intellijoint Surgical, Smith & Nephew.All other authors declare that there is no conflict of interest.

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