Use of a fluoroscopy-based robotic-assisted total hip arthroplasty system produced greater improvements in patient-reported outcomes at one year compared to manual, fluoroscopic-assisted technique

• Published in: Archives of orthopaedic and trauma surgery 2024-04, Vol.144 (4), p.1843-1850
• Main Authors: Buchan, Graham B.J., Ong, Christian B., Hecht II, Christian J., DeCook, Charles A., Spencer-Gardner, Luke S., Kamath, Atul F.
• Format: Article
• Language: English
• Subjects: Arthritis; Arthroplasty, Replacement, Hip - methods; Clinical outcomes; Fluoroscopy; Hip Arthroplasty; Humans; Joint replacement surgery; Medicine; Medicine & Public Health; Orthopedics; Osteoarthritis; Pain; Patient Reported Outcome Measures; Patients; Robotic Surgical Procedures - methods; Robotics; Technology adoption; Treatment Outcome
• ISSN: 1434-3916; 0936-8051; 1434-3916
• DOI: 10.1007/s00402-024-05230-8

Introduction The adoption of new technology should be supported by improvements in patient-reported outcomes (PROMs). The purpose of this study was to assess the one-year PROMs of patients who underwent total hip arthroplasty (THA) using a novel, fluoroscopy-based, robotic-assisted (RA-THA) system when compared to a manual, fluoroscopic-assisted technique (mTHA). Materials and methods A review of 91 consecutive mTHA and 85 consecutive RA-THA via a direct anterior approach was conducted. All cases were performed by the same surgeon at the same institution, for a pre-operative diagnosis of osteoarthritis, avascular necrosis, or rheumatoid arthritis. Outcomes included one-year Veterans RAND-12 (VR-12) Physical/Mental, Hip Disability and Osteoarthritis Outcome (HOOS) Pain/Physical Function/Joint Replacement, and University of California Los Angeles (UCLA) Activity scores, as well as the difference between pre-operative and one-year post-operative PROMs. Results Patients in the RA-THA cohort had lower pre-operative HOOS-JR scores compared to patients in the mTHA cohort (37.0 vs. 43.1; p  = 0.031). Cohorts experienced similar one-year post-operative VR-12, HOOS, and UCLA Activity scores. Patients in the RA-THA cohort experienced greater improvements across all pre- and post-operative HOOS scores compared to patients in the mTHA cohort: Pain (+ 54.7 vs. +42.1; p  = 0.009), Physical Function (-41.6 vs. -28.7; p  = 0.007), and Joint Replacement (+ 46.6 vs. +33.0; p  = 0.002). These differences exceeded minimum clinically important difference (MCID). Conclusions Both manual and robotic cohorts experienced benefit from THA at one-year post-operative. Importantly, the use of a novel, fluoroscopy-based robotic assistance system for primary THA resulted in greater improvements in PROMs at one-year relative to manual technique.