Computer-assisted fluoroscopic navigation may show benefits vs. robotic-assisted THA
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Key takeaways:
- Computer-assisted fluoroscopic navigation for total hip arthroplasty yielded decreased OR times and hospital costs vs. robotic-assisted surgery.
- Both procedures yielded low rates of readmissions and revisions.
Published results showed total hip arthroplasty with computer-assisted fluoroscopic navigation may yield decreased OR times and costs with comparable clinical outcomes vs. robotic-assisted surgery.
“Different technologies in hip replacement have different advantages and need to be considered separately instead of all under one ‘technology’ umbrella,” Jenna Bernstein, MD, assistant clinical professor of surgery at Quinnipiac University and attending surgeon of adult reconstruction at Connecticut Orthopaedics, told Healio. “Fluoroscopic-based navigation, in this study, was shown to be more efficient and have a lower cost while still having similar — if not better — outcomes compared to robotic hip replacements.”
Bernstein and colleagues retrospectively studied data from 4,378 computer-assisted, fluoroscopically navigated THAs and 10,423 robotic-assisted THAs that were performed between January 2016 and September 2021 with minimum 90-day follow-up.
According to the study, Bernstein and colleagues compared OR times, readmission rates, length of stay (LOS), discharge disposition, revision rates and hospital costs between the cohorts.
Computer-assisted fluoroscopic navigation yielded significantly decreased mean OR time (137.74 minutes vs. 156 minutes) and implant-related readmission rates at 90 days (1.26% vs. 2.21%) and 1 year (2.05% vs. 3.42%) compared with robotic-assisted surgery. Bernstein and colleagues also found significantly decreased rates of all-cause readmissions for the computer-assisted fluoroscopic navigation cohort vs. the robotic-assisted cohort at 90 days (2.59% vs. 3.5%) and 1 year (6.22% vs. 8.01%).
In addition, computer-assisted fluoroscopic navigation yielded an increased proportion of patients discharged home or to home health services (94.17% vs. 91.35%), a decreased proportion of patients discharged to a skilled nursing facility (4.21% vs. 5.92%), decreased hospital LOS (1.54 vs. 1.68 days), decreased rates of revision at 90 days (0.07% vs. 0.24%) and 1 year (0.09% vs. 0.18%) and decreased hospital costs ($17,265 vs. $18,657) compared with robotic-assisted surgery.
“When surgeons consider whether to add new technology in their hip arthroplasty practice, if efficiency and cost are concerns in adoption, this study can quell those concerns about using fluoroscopic navigation,” Bernstein said.
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