Prinos Alana, Buehring Weston, Di Gangi Catherine, Meere Patrick, Meftah Morteza, Hepinstall Matthew
Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA.
Arthroplast Today. 2024 May 11;27:101393. doi: 10.1016/j.artd.2024.101393. eCollection 2024 Jun.
The utilization of technology, including robotics and computer navigation, in total hip arthroplasty (THA) has been steadily increasing; however, conflicting data exists regarding its effect on short-term clinical and patient-reported outcomes. Therefore, this study sought to explore the association between different surgical technologies and postoperative outcomes following THA.
We retrospectively reviewed 9892 primary THA cases performed by 62 surgeons from a single institution from September 2017 to November 2022. Three cohorts were created based on the utilization of technology: conventional (no technology), navigation, or robotics. Patient demographics, clinical outcomes, and patient-reported outcome measures were collected over the first 90 days following surgery. This data was compared using analysis of variance and multivariate logistic regressions. In total, 4275 conventional, 4510 navigation, and 1107 robotic cases were included in our analyses.
The robotic cohort achieved a perfect Activity Measure for Post-Acute Care (AM-PAC) score earliest (0.1 days, < .001). After adjusting for potential confounding variables, use of robotic assistance was associated with greater odds of achieving a perfect AM-PAC score on postoperative day 0 (odds ratio 1.6, < .001) and greater odds of having length of stay shorter than 24 hours (odds ratio 2.3, < .001) compared to no technology use in THA. Hip dysfunction and Osteoarthritis Outcome Score, Joint Replacement and Patient-Reported Outcomes Measurement Information System Pain Interference scores showed the greatest improvement in the robotic cohort at both 6 weeks and 3 months following surgery.
The present study demonstrates favorable clinical and patient-reported outcomes in the first 90 days following surgery for patients undergoing robot-assisted THA compared to conventional and navigation-assisted THA.
在全髋关节置换术（THA）中，包括机器人技术和计算机导航在内的技术应用一直在稳步增加；然而，关于其对短期临床和患者报告结局的影响，存在相互矛盾的数据。因此，本研究旨在探讨不同手术技术与THA术后结局之间的关联。
我们回顾性分析了2017年9月至2022年11月期间，由同一机构的62位外科医生进行的9892例初次THA病例。根据技术应用情况创建了三个队列：传统手术（无技术辅助）、导航辅助或机器人辅助。收集了患者术后前90天的人口统计学数据、临床结局和患者报告的结局指标。使用方差分析和多因素逻辑回归对这些数据进行比较。我们的分析共纳入了4275例传统手术、4510例导航辅助手术和1107例机器人辅助手术的病例。
机器人辅助队列最早达到急性后期护理活动量表（AM-PAC）满分（0.1天，P<0.001）。在调整潜在混杂变量后，与THA中不使用技术相比，使用机器人辅助在术后第0天达到AM-PAC满分的几率更高（优势比1.6，P<0.001），住院时间短于24小时的几率也更高（优势比2.3，P<0.001）。在术后6周和3个月时，机器人辅助队列的髋关节功能障碍和骨关节炎结局评分、关节置换和患者报告结局测量信息系统疼痛干扰评分改善最为明显。
本研究表明，与传统手术和导航辅助THA相比，接受机器人辅助THA的患者在术后90天内具有更好的临床和患者报告结局。
