Rogers Nathan, Rullán Pedro J, Pasqualini Ignacio, Khan Shujaa T, Klika Alison K, Surace Peter A, Molloy Robert M, Piuzzi Nicolas S, Bloomfield Michael
Technol Health Care. 2024;32(5):3769-3781. doi: 10.3233/THC-231646.
The value of robotic-assisted total hip arthroplasty (rTHA) has yet to be determined compared to conventional manual THA (mTHA).
Evaluate 90-day inpatient readmission rates, rates of reoperation, and clinically significant improvement of patient-reported outcome measures (PROMs) at 1-year in a cohort of patients who underwent mTHA or rTHA through a direct anterior (DA) approach.
A single-surgeon, prospective institutional cohort of 362 patients who underwent primary THA for osteoarthritis via the DA approach between February 2019 and November 2020 were included. Patient demographics, surgical time, discharge disposition, length of stay, acetabular cup size, 90-day inpatient readmission, 1-year reoperation, and 1-year PROMs were collected for 148 manual and 214 robotic THAs, respectively.
Patients undergoing rTHA had lower 90-day readmission (3.74% vs 9.46%, p= 0.04) and lower 1-year reoperation (0.93% vs 4.73% mTHA, p= 0.04). rTHA acetabular cup sizes were smaller (rTHA median 52, interquartile range [IQR] 50; 54, mTHA median 54, IQR 52; 58, p< 0.001). Surgical time was longer for rTHA (114 minutes vs 101 minutes, p< 0.001). At 1-year post-operatively, there was no difference in any of the PROMs evaluated.
Robotic THA demonstrated lower 90-day readmissions and 1-year reoperation rates than manual THA via the DA approach. PROMs were not significantly different between the two groups at one year.
与传统人工全髋关节置换术(mTHA)相比,机器人辅助全髋关节置换术(rTHA)的价值尚未确定。
评估一组通过直接前路(DA)入路接受mTHA或rTHA的患者在90天内的住院再入院率、再次手术率以及1年时患者报告结局指标(PROMs)的临床显著改善情况。
纳入2019年2月至2020年11月期间由同一外科医生进行的、通过DA入路因骨关节炎接受初次THA的362例患者的前瞻性机构队列研究。分别收集了148例人工THA和214例机器人THA患者的数据,包括患者人口统计学信息、手术时间、出院处置情况、住院时间、髋臼杯尺寸、90天内住院再入院情况、1年时再次手术情况以及1年时的PROMs。
接受rTHA的患者90天再入院率较低(3.74%对9.46%,p = 0.04),1年再次手术率也较低(rTHA为0.93%,mTHA为4.73%,p = 0.04)。rTHA的髋臼杯尺寸较小(rTHA中位数为52,四分位间距[IQR]为50;54,mTHA中位数为54,IQR为52;58,p < 0.001)。rTHA的手术时间更长(114分钟对101分钟,p < 0.001)。术后1年,所评估的任何PROMs均无差异。
与通过DA入路的人工THA相比,机器人THA的90天再入院率和1年再次手术率更低。两组在1年时的PROMs无显著差异。