Robotic-assisted Total Hip Arthroplasty - Clinical Outcomes and Complication Rate

Background: While total hip arthroplasty (THA) is known to be one of the most successful orthopedic procedures, there is still room for improvement. Current literature has shown that robotic-assisted THA yields high component placement accuracy and reproducibility. In this study, we aim to report minimum two-year clinical outcomes and complication rates in patients that underwent anterior- and posterior-approach robotic-assisted THA.

Methods: Data were prospectively collected and retrospectively reviewed for all primary THAs for the treatment of osteoarthritis at our institution between August 2011 and March 2014. Inclusion criteria were patients who underwent robotic-assisted THA with minimum 2-year follow-up. Active worker’s compensation claims were excluded. Demographics, operating time, intra- and post-operative complications, and 2-year outcome scores were recorded. We collected modified Harris Hip Score (mHHS), Forgotten Joint Score (FJS-12), Visual Analog Scale (VAS), and patient satisfaction.

Results: Two hundred surgical cases were eligible for inclusion, of which 178 (89%) had minimum 2-year follow-up. Posterior approach was used in 126 patients and anterior was used in 52. Mean age was 59.4 and mean BMI was 29.4. At latest follow-up, patient satisfaction was 9.2 (± 2.2), VAS was 0.8 (± 1.5), FJS-12 was 79.1 (± 23.6), and mHHS was 91.1 (± 13.3). Mean time of surgery was 76.7 min (± 20.1). A subgroup analysis of 20 patients that had prior ipsilateral hip arthroscopy showed significantly lower VAS, FJS-12, and mHHS. Age and gender were not significantly different between the anterior and posterior groups, but BMI and operative time were. Outcomes and specific complication rates between posterior and anterior approaches were not significantly different from each other.

Conclusion: Robotic-assisted THA is a safe procedure and shows good short-term outcomes. Prior ipsilateral hip arthroscopy may worsen outcomes, but further investigation is needed to examine this relationship as this study’s prior arthroscopy group was very small.