Robotic-assisted THA may be associated with less opioid use vs. conventional THA
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Key takeaways:
- Robotic-assisted hip arthroplasty may decrease postoperative opioid use vs. conventional surgery.
- Robotic-assisted surgery was linked with reduced rates of new, persistent opioid use among opioid-naïve patients.
Published results showed robotic-assisted total hip arthroplasty was associated with decreased postoperative opioid use and lower odds of patients developing persistent opioid use compared with conventional THA.
Thompson Zhuang, MD, MBA, an orthopedic surgery resident from the department of orthopedic surgery at the University of Pennsylvania, and colleagues performed a retrospective cohort study of data for 1,169,377 patients who underwent conventional THA and 14,331 patients who underwent robotic-assisted THA.
Zhuang and colleagues assessed morphine milligram equivalents (MMEs) filled per patient and per day for postoperative use within 14 days after surgery. They also assessed the development of new and persistent opioid use among a cohort of opioid-naïve patients. They compared these outcomes between patients who underwent robotic-assisted THA vs. conventional THA.
Overall, robotic-assisted THA was associated with fewer mean total MMEs filled per patient (452.2 vs. 517.1) and fewer mean total MMEs filled per patient per day (71.53 vs. 74.64) compared with conventional THA.
Among opioid-naïve patients, Zhuang and colleagues found robotic-assisted THA was associated with a lower rate of new and persistent opioid use (4.6%) compared with conventional THA (5.2%; OR = 0.82).
“Our data tentatively support the adoption of robotic-assisted THA across health systems, which could facilitate reductions in postoperative opioid use,” Zhuang and colleagues wrote in the study.
Perspective
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I commend the authors for their insightful investigation into the impact of robotic-assisted total hip arthroplasty on postoperative opioid use. The optimization of pain management with a conservative approach to opioid usage is of paramount importance in contemporary orthopedic practice, especially in light of the ongoing opioid epidemic. The study findings — that robotic-assisted THA is associated with significantly lower postoperative opioid consumption and reduced odds of new, persistent opioid use — are particularly encouraging.
Robotic technology in joint replacement surgery is rapidly gaining traction, and this research provides critical early data suggesting its potential benefits in reducing opioid dependence. By demonstrating a statistically significant reduction in both the mean total morphine milligram equivalents filled per patient and the mean morphine milligram equivalents per patient per day, the authors offer valuable evidence that supports further exploration and validation of these findings.
The implications of this study extend beyond immediate postoperative pain management, highlighting a promising avenue for improving long-term patient outcomes through the integration of robotic-assisted techniques. This pioneering work sets a foundation for future research and underscores the importance of continuous innovation in surgical practices to enhance patient care and safety. However, it is important to approach these findings with cautious optimism, as further studies are needed to fully validate and understand the long-term implications of robotic-assisted THA on opioid use.
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