Shah Aakash K, Lavu Monish S, Burkhart Robert J, Hecht Christian J, Blackburn Collin, Romeo Nicholas
Case Western Reserve University School of Medicine, Cleveland, OH, 44106, USA.
Department of Orthopaedic Surgery, University Hospitals, Cleveland, OH, 44106, USA.
Arch Orthop Trauma Surg. 2025 Jan 7;145(1):114. doi: 10.1007/s00402-024-05628-4.
The outcomes of total hip arthroplasty (THA) are highly dependent upon the restoration of native hip biomechanics and optimal component positioning. Robotic technologies for THA have rapidly improved the accuracy of component positioning and maintaining the planned center of rotation. While robotic-assisted THA (RA-THA) has primarily been employed in surgically intricate cases, its potential benefits in scenarios of diminished surgical complexity remain less explored. Therefore, the purpose of this study was to assess the odds of developing systemic and joint complications following RA-THA in cases of reduced surgical complexity.
A retrospective cohort study was conducted using the TriNetX national database to identify patients who underwent primary THA (Current Procedural Terminology code 27,130) and more specifically RA-THA identified by ICD-10-PCS code 8E0Y0CZ and Healthcare Common Procedure Coding System code S2900 from 2013 to 2022. One-to-one propensity score matching was conducted to generate 2 cohorts: (1) RA-THA and (2) conventional THA (C-THA). Systemic and joint complications were assessed at the 30-day, 90-day, 1-year, and 5-year postoperative periods.
Patients undergoing RA-THA had a lower risk of needing a revision THA at the 90-day, 1-year, and 5-year time points. RA-THA was associated with a lower risk of prosthetic dislocation at 90 days and 1 year and prosthetic pain at 1 year and 5 years. Dislocation of the hip or fracture of the femur was significantly lower in the RA-THA cohort at all four-time points. Patients undergoing RA-THA had a lower risk of developing deep vein thrombosis at 5 years.
These findings suggest that RA-THA has comparable systemic and less joint complication risks at 30-day to 5-year timepoints between RA-THA and C-THA. Future studies with large sample sizes and long-term follow-up are needed to understand the patient-reported outcomes and functional outcomes of RA-THA for cases with reduced surgical complexity.
全髋关节置换术（THA）的疗效高度依赖于恢复天然髋关节生物力学和实现组件的最佳定位。用于THA的机器人技术已迅速提高了组件定位的准确性并维持计划的旋转中心。虽然机器人辅助THA（RA-THA）主要用于手术复杂的病例，但其在手术复杂性降低的情况下的潜在益处仍有待进一步探索。因此，本研究的目的是评估手术复杂性降低的病例中RA-THA后发生全身和关节并发症的几率。
使用TriNetX国家数据库进行了一项回顾性队列研究，以识别接受初次THA（当前程序术语代码27130）的患者，更具体地说是通过ICD-10-PCS代码8E0Y0CZ和医疗保健通用程序编码系统代码S2900识别的2013年至2022年期间的RA-THA患者。进行一对一倾向评分匹配以生成两个队列：（1）RA-THA和（2）传统THA（C-THA）。在术后30天、90天、1年和5年评估全身和关节并发症。
接受RA-THA的患者在90天、1年和5年时间点进行翻修THA的风险较低。RA-THA与90天和1年时假体脱位风险较低以及1年和5年时假体疼痛风险较低相关。在所有四个时间点，RA-THA队列中髋关节脱位或股骨骨折的发生率均显著较低。接受RA-THA的患者在5年时发生深静脉血栓形成的风险较低。
这些发现表明，在30天至5年的时间点，RA-THA与C-THA相比，具有相当的全身并发症风险和较低的关节并发症风险。未来需要进行大样本量和长期随访的研究，以了解手术复杂性降低的病例中RA-THA患者报告的结局和功能结局。
