Keck School of Medicine of USC, Los Angeles, CA, USA.
University of South Carolina School of Medicine, Columbia, SC, USA.
Hip Int. 2024 Sep;34(5):569-577. doi: 10.1177/11207000241264256. Epub 2024 Aug 8.
As the volume of technology-assisted total hip arthroplasty (THA) increases, there is a need to characterise the outcomes of robotic-assisted (RA) and computer-navigated (CN) THA. The goal of this study was to assess outcomes and opioid consumption following CN-THA and RA-THA compared to conventionally-instrumented (CON) THA.
The Premier Database was queried for all patients who underwent primary, elective THA from 2015-2020. Patients were divided into 3 groups: CN, RA, or CON-THA. Yearly usage trends were assessed. Univariate and multivariate analyses were performed to assess the 90-day risk of postoperative complications. Opioid consumption was reported in morphine milligram equivalents (MME) for postoperative days (POD) 0 and 1.
Overall, 474,707 elective THAs were identified (95.7% CON, 2.1% CN, 2.2% RA. After accounting for confounders, CN-THA patients were at decreased risk for periprosthetic joint infection (PJI) (aOR: 0.55, < 0.001) and dislocation (aOR 0.45, < 0.001), but increased risk for blood transfusion (aOR 1.97, <0.001) compared to CON-THA. RA-THA patients were at decreased risk of dislocation (aOR:0.66, < 0.001) but increased risk for transfusion (aOR 1.20, < 0.001), prosthesis breakage (aOR 3.88, < 0.001), and periprosthetic fracture (aOR 1.72, < 0.001). Opioid consumption for CN-THA patients was lower on POD1 and lower for RA-THA patients POD0 and 2 compared to CON-THA.
CN-THA was associated with reduced rates of PJI and dislocation, but increased rates of blood transfusion while RA-THA was associated with decreased rates of dislocation, but increased rates of blood transfusion, prosthesis complications, and periprosthetic fracture compared to CON-THA. Technology-assisted THA was associated with lower postoperative opioid consumption.
随着技术辅助全髋关节置换术（THA）数量的增加，需要对机器人辅助（RA）和计算机导航（CN）THA 的结果进行描述。本研究的目的是评估 CN-THA 和 RA-THA 与传统仪器辅助（CON）THA 相比的术后结果和阿片类药物的使用情况。
从 2015 年至 2020 年，对 Premier 数据库中所有接受初次、择期 THA 的患者进行了查询。患者分为 3 组：CN、RA 或 CON-THA。评估了每年的使用趋势。进行了单变量和多变量分析，以评估术后 90 天内发生术后并发症的风险。术后第 0 天和第 1 天，以吗啡毫克当量（MME）报告了阿片类药物的使用量。
共确定了 474,707 例择期 THA（95.7% CON、2.1% CN、2.2% RA）。在考虑了混杂因素后，CN-THA 患者发生假体周围关节感染（PJI）的风险降低（aOR：0.55，<0.001）和脱位（aOR：0.45，<0.001），但输血风险增加（aOR：1.97，<0.001）与 CON-THA 相比。RA-THA 患者脱位风险降低（aOR：0.66，<0.001），但输血（aOR：1.20，<0.001）、假体断裂（aOR：3.88，<0.001）和假体周围骨折（aOR：1.72，<0.001）风险增加。与 CON-THA 相比，CN-THA 患者术后第 1 天的阿片类药物使用量较低，RA-THA 患者术后第 0 天和第 2 天的阿片类药物使用量较低。
与 CON-THA 相比，CN-THA 与较低的 PJI 和脱位发生率相关，但输血发生率较高，而 RA-THA 与较低的脱位发生率相关，但与 CON-THA 相比，输血、假体并发症和假体周围骨折的发生率较高。与 CON-THA 相比，使用技术辅助 THA 与术后阿片类药物使用量较低相关。
