Robotic-assistance is associated with better joint outcomes compared to conventional techniques in surgically routine total hip arthroplasty: a propensity-matched large database study of 3948 patients

Introduction: The outcomes of total hip arthroplasty (THA) are highly dependent upon the restoration of native hip biomechanics and optimal component positioning. Robotic technologies for THA have rapidly improved the accuracy of component positioning and maintaining the planned center of rotation. While robotic-assisted THA (RA-THA) has primarily been employed in surgically intricate cases, its potential benefits in scenarios of diminished surgical complexity remain less explored. Therefore, the purpose of this study was to assess the odds of developing systemic and joint complications following RA-THA in cases of reduced surgical complexity.

Methods: A retrospective cohort study was conducted using the TriNetX national database to identify patients who underwent primary THA (Current Procedural Terminology code 27,130) and more specifically RA-THA identified by ICD-10-PCS code 8E0Y0CZ and Healthcare Common Procedure Coding System code S2900 from 2013 to 2022. One-to-one propensity score matching was conducted to generate 2 cohorts: (1) RA-THA and (2) conventional THA (C-THA). Systemic and joint complications were assessed at the 30-day, 90-day, 1-year, and 5-year postoperative periods.

Results: Patients undergoing RA-THA had a lower risk of needing a revision THA at the 90-day, 1-year, and 5-year time points. RA-THA was associated with a lower risk of prosthetic dislocation at 90 days and 1 year and prosthetic pain at 1 year and 5 years. Dislocation of the hip or fracture of the femur was significantly lower in the RA-THA cohort at all four-time points. Patients undergoing RA-THA had a lower risk of developing deep vein thrombosis at 5 years.

Conclusion: These findings suggest that RA-THA has comparable systemic and less joint complication risks at 30-day to 5-year timepoints between RA-THA and C-THA. Future studies with large sample sizes and long-term follow-up are needed to understand the patient-reported outcomes and functional outcomes of RA-THA for cases with reduced surgical complexity.