Robotic-assisted THA provides more reliable cup positioning, stability vs. manual THA
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Compared with manual total hip arthroplasty, robotic-assisted THA produced more reliable cup positioning and offered superior protection against dislocation and revision, according to published results.
In a three-surgeon cohort study, Jonathan H. Shaw, MD, and colleagues analyzed 1,724 patients who underwent manual primary THA (M-THA) and 523 patients who underwent robotic-assisted primary THA (R-THA) between January 2014 and June 2020 at a single hospital.
Researchers used the Michigan Arthroplasty Registry Collaborative Quality Initiative to assess outcome measures, such as dislocation, instability, revision, readmissions, 90-day complication rates and ED visits. Additionally, researchers performed multivariate regression analysis on a representative, randomized sample of 368 anteroposterior pelvis radiographs taken after THA to assess acetabular implant positioning. According to the study, average follow-up was 4 years (minimum follow-up of 6 months).
Shaw and colleagues found significantly lower rates of dislocation in the R-THA cohort (0.6%) compared with the M-THA cohort (2.5%). All cases of dislocation after R-THA were successful with conservative treatment without recurrence, while 46% of cases of dislocation after M-THA required revision for recurrent instability.
Of the 368 sample radiographs included for cup position analysis, 141 were cases of R-THA and 227 were cases of M-THA. Researchers found cup anteversion was 25.6° after R-THA compared with 20.6° after M-THA, while cup inclination was 42.5° after R-THA compared with 47° after M-THA.
“R-THA resulted in less than one-fourth the dislocation rate compared to M-THA and no revision for instability. It was associated with no difference in [patient-reported outcome measures] PROMs or other early complications,” the researchers wrote in the study. “It adds to the literature that R-THA continues to produce reliable cup positioning that could contribute to this cohort's decreased dislocation rate,” they wrote.
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