Comparison of Postoperative Instability and Acetabular Cup Positioning in Robotic-Assisted Versus Traditional Total Hip Arthroplasty

Shaw, Jiajiu; Rahman, Tahsin; Wesemann, Luke; Jiang, Charles; Darrith, Brian; Davis, Jason J.

doi:10.1016/j.arth.2022.02.002

Cited by 23 publications

(11 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Logistic regression analysis revealed that the use of CN was not associated with a significant difference in the rate of PJI (OR, 1.8 [95% CI, 0.7 to 5.3]; p = 0.232) (Table II). A lthough computer navigation and robotic assistance are currently used in a minority of THA procedures 1,2 , the increase in the use of such technology appears to be inevitable in the coming decades, driven mostly by the assurance that it increases the accuracy of implant placement and decreases the risk of postoperative instability [4][5][6][7][8][9][10][11]23 . Nevertheless, PJI remains a common reason for revision THA; therefore, a formal analysis to determine if technological aids increase infection risk is both timely and necessary.…”

Section: Resultsmentioning

confidence: 99%

Robotics and Navigation Do Not Affect the Risk of Periprosthetic Joint Infection Following Primary Total Hip Arthroplasty

LaValva,

Chiu,

Fowler

et al. 2024

Journal of Bone and Joint Surgery

View full text Add to dashboard Cite

Background: The use of computer navigation or robotic assistance during primary total hip arthroplasty (THA) has yielded numerous benefits due to more accurate component positioning. The utilization of these tools is generally associated with longer operative times and also necessitates additional surgical equipment and personnel in the operating room. Thus, the aim of this study was to evaluate the impact of technology assistance on periprosthetic joint infection (PJI) after primary THA. Methods: We retrospectively reviewed the records for 12,726 patients who had undergone primary THA at a single high-volume institution between 2018 and 2021. Patients were stratified by surgical technique (conventional THA, computer-navigated THA [CN-THA], or robotic-assisted THA [RA-THA]) and were matched 1:1 with use of propensity score matching. Univariate and logistic regression analyses were performed to compare the rates of PJI within 90 days postoperatively between the cohorts. Results: After propensity score matching, there were 4,006 patients in the THA versus RA-THA analysis (2,003 in each group) and 5,288 patients in the THA versus CN-THA analysis (2,644 in each group). CN-THA (p < 0.001) and RA-THA (p < 0.001) were associated with longer operative times compared with conventional THA by 3 and 11 minutes, respectively. The rates of PJI after conventional THA (0.2% to 0.4%) were similar to those after CN-THA (0.4%) and RA-THA (0.4%). On the basis of logistic regression, the development of PJI was not associated with the use of computer navigation (odds ratio [OR], 1.8 [95% confidence interval (CI), 0.7 to 5.3]; p = 0.232) or robotic assistance (OR, 0.9 [95% CI, 0.3 to 2.3]; p = 0.808). Conclusions: Despite longer operative times associated with the use of computer navigation and robotic assistance, the use of these tools was not associated with an increased risk of PJI within 90 days after surgery. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

show abstract

Section: Resultsmentioning

confidence: 99%

Robotics and Navigation Do Not Affect the Risk of Periprosthetic Joint Infection Following Primary Total Hip Arthroplasty

LaValva,

Chiu,

Fowler

et al. 2024

Journal of Bone and Joint Surgery

View full text Add to dashboard Cite

show abstract

“…Robotic assisted THA, which helps with implant positioning, has been shown to help reduce dislocation rates compared to conventional THA. Shaw et al found, in their cohort of 2247 patients, that the dislocation rate 0.60% with robotic assisted THA vs. 2.50% in the conventional THA cohort [ 11 ]. In addition to technical factors, patient characteristics and comorbidities also play a role in dislocation rates.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of total hip arthroplasty: demographics, comorbidities and outcomes

et al. 2023

View full text Add to dashboard Cite

Background Primary THA (THA) is a successful procedure for end-stage hip osteoarthritis. In the setting of a failed THA, revision total hip arthroplasty (rTHA) acts as a salvage procedure. This procedure has increased risks, including sepsis, infection, prolonged surgery time, blood loss, and increased length of stay. Increasing focus on understanding of demographics, comorbidities, and inpatient outcomes can lead to better perioperative optimization and post-operative outcomes. This epidemiological registry study aimed to compare the demographics, comorbidity profiles, and outcomes of patients undergoing THA and rTHA. Methods A retrospective review of discharge data reported from 2006 to the third quarter of 2015 using the National Inpatient Sample registry was performed. The study included adult patients aged 40 and older who underwent either THA or rTHA. A total of 2,838,742 THA patients and 400,974 rTHA patients were identified. Results The primary reimbursement for both THA and rTHA was dispensed by Medicare at 53.51% and 65.36% of cases respectively. Complications arose in 27.32% of THA and 39.46% of rTHA cases. Postoperative anemia was the most common complication in groups (25.20% and 35.69%). Common comorbidities in both groups were hypertension and chronic pulmonary disease. rTHA indications included dislocation/instability (21.85%) followed by mechanical loosening (19.74%), other mechanical complications (17.38%), and infection (15.10%). Conclusion Our data demonstrated a 69.50% increase in patients receiving THA and a 28.50% increase in rTHA from the years 2006 to 2014. The data demonstrated 27.32% and 39.46% complication rate with THA and rTHA, with postoperative anemia as the most common cause. Common comorbidities were hypertension and chronic pulmonary disease. Future analyses into preoperative optimizations, such as prior consultation with medical specialists or improved primary hip protocol, should be considered to prevent/reduce postoperative complications amongst a progressive expansion in patients receiving both THA and rTHA.

show abstract

“…In a randomized controlled trial comparing 62 computer navigated THAs to 63 manual THAs, Lass et al found no difference in dislocation rates at a minimum of 2 year follow up [110]. In their cohort of 2247 patients, Shaw et al found robotic assisted THA to result in significantly lower rates of dislocation (0.6%) versus manual THA (2.5%, p < 0.05) [111]. Another recent study compared THAs performed through the posterior approach using robotic assisted, computer navigated, and manual techniques [112].…”

Section: Robotics/fluoroscopy and Navigation Cup Positionmentioning

confidence: 99%

Instability in Total Hip Arthroplasty

Panwar¹,

Cutter²,

Holmboe³

et al. 2023

Arthroplasty - Advanced Techniques and Future Perspectives

View full text Add to dashboard Cite

Total hip arthroplasty (THA) is becoming one of the most frequently sought-after surgeries in orthopedics. As the techniques and implants continue to evolve, the stability of the prosthesis is always at the forefront of the surgeon’s mind. Multiple factors contribute to implant stability and there are many intraoperative decisions that can be made by the surgeon to increase stability. Techniques including approaches, adjusting length, adjusting offset, as well as implant choices can dictate stability in THA. There are multiple options that exist including different liners and constraint. One non modifiable variable which surgeons often struggle with is the spinopelvic relationship which can also affect stability post operatively. These factors include lumbar arthritis, variable pelvic tilt, and others that can make a routine approach to a total hip unsuccessful and increase the risk of post-operative complications. Ultimately there are many things to consider when approaching THA in patients, especially in the setting of abnormal pathology.

show abstract

Comparison of Postoperative Instability and Acetabular Cup Positioning in Robotic-Assisted Versus Traditional Total Hip Arthroplasty

Cited by 23 publications

References 37 publications

Robotics and Navigation Do Not Affect the Risk of Periprosthetic Joint Infection Following Primary Total Hip Arthroplasty

Robotics and Navigation Do Not Affect the Risk of Periprosthetic Joint Infection Following Primary Total Hip Arthroplasty

Epidemiology of total hip arthroplasty: demographics, comorbidities and outcomes

Instability in Total Hip Arthroplasty

Contact Info

Product

Resources

About