O'Donnell Jeffrey A, Buchalter Daniel B, Borsinger Tracy M, Chandi Sonia K, Neitzke Colin C, Westrich Geoffrey H, Gausden Elizabeth B
Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.
Department of Orthopaedic Surgery, University of Virginia Medical Center, Charlottesville, VA, USA.
Hip Int. 2025 Jul;35(4):402-409. doi: 10.1177/11207000241312385. Epub 2025 Jan 20.
Total hip arthroplasty (THA) is widely used for active, elderly patients with femoral neck fractures (FNF). Compared to THA for osteoarthritis, THA for FNF is associated with a higher incidence of dislocation and reoperation. Robotic assistance may improve component positioning and leg-length restoration in THA, but its use in FNF has not been described. The objective of this study was to assess the feasibility and perioperative outcomes of robotic-assisted THA (rTHA) for FNF.
A retrospective review identified 93 patients undergoing 94 THAs for FNF from 2016 to 2023. 18 patients treated with MAKOplasty rTHA were compared to 76 non-rTHA. There were 69 (73%) women, the mean age was 71 years, and the mean follow-up was 3 years.
There was no significant difference in operative time between rTHA and non-rTHA cohorts (100 vs. 108 minutes, = 0.19), and sub-analysis of acute FNFs (< 6 weeks), showed no difference in the meantime from presentation to surgery (18 vs. 25 hours, = 0.24). There was no significant difference in mean leg-length discrepancy (LLD) ( = 0.19), number of outliers for acetabular anteversion ( = 0.80), or inclination ( = 0.55). There were no postoperative dislocations or reoperations in the rTHA cohort, compared to 4 dislocations (5%) and 6 reoperations (8%) in the non-rTHA cohort ( = 1.00 and 0.59, respectively).
In this series of THA for FNF, robotic assistance did not significantly delay the time to surgery or increase the operative time compared to non-rTHA. At a mean follow-up of 3 years, there were no postoperative dislocations or reoperations in the rTHA cohort.
全髋关节置换术（THA）广泛应用于活跃的老年股骨颈骨折（FNF）患者。与用于骨关节炎的THA相比，用于FNF的THA脱位和再次手术的发生率更高。机器人辅助可能会改善THA中假体的定位和肢体长度恢复，但尚未见其在FNF中的应用报道。本研究的目的是评估机器人辅助THA（rTHA）治疗FNF的可行性和围手术期结果。
一项回顾性研究确定了2016年至2023年期间93例接受94次THA治疗FNF的患者。将18例接受MAKOplasty rTHA治疗的患者与76例非rTHA患者进行比较。其中有69例（73%）女性，平均年龄为71岁，平均随访时间为3年。
rTHA组和非rTHA组的手术时间无显著差异（100分钟对108分钟，P = 0.19），对急性FNF（<6周）的亚分析显示，从就诊到手术的时间无差异（18小时对25小时，P = 0.24）。平均肢体长度差异（LLD）（P = 0.19）、髋臼前倾角异常值数量（P = 0.80）或倾斜度（P = 0.55）均无显著差异。rTHA组无术后脱位或再次手术，而非rTHA组有4例脱位（5%）和6例再次手术（8%）（P分别为1.00和0.59）。
在这一系列FNF的THA中，与非rTHA相比，机器人辅助并未显著延迟手术时间或增加手术时间。平均随访3年时，rTHA组无术后脱位或再次手术。
