Robotic-assisted total hip arthroplasty yields enhanced surgical and clinical outcomes compared to manual hip arthroplasty using the same implant system

4 pages•Published: October 26, 2019

Seth Jerabek, Russell Cohen, Alana Levine, Alice Cruz and Laura Scholl

Abstract

In a prospective, non-randomized trial, 222 hips across seven centers received the same THA system of a tapered wedge stem and novel additively manufactured titanium porous clusterhole acetabular shell in primary THA. 113 hips were implanted with a robotic-assisted surgical system while 109 hips were implanted manually. The robotic-assisted cohort yielded a similar mean skin-to-skin surgical time of 80.35 minutes compared to 79.35 minutes for the manual cohort (p=0.8895), along with a shorter hospital stay of 0.96 days compared to 1.59 days (p<0.0001). The robotic-assisted cohort resulted in a lower blood loss of 199.8 cc compared to 310.1 cc for the manual cohort (p<0.0001). Standard deviation for incision length was 81% of the value in robotic-assisted cases when comparing with manual cases (2.2 cm vs. 2.7cm). Robotic-assisted THA cases demonstrated improved clinical outcomes with a higher 6-week postoperative HHS (81.0 vs. 78.4), physical VR-12 (39.5 vs. 35.9), and LEAS (9.2 vs. 8.0). The EQ-5D treatment effect size at 6-weeks postoperative for robotic-assisted cases exceeded a large effect with a value of 0.91, while the effect size for manual cases was 0.59. Robotic-assisted 3-D patient specific planning and haptically guided robotic-assisted surgical execution demonstrated an improved operative experience relative to blood loss, and incision length. The robotic cohort also yielded improved early clinical and functional outcomes when comparted to manual techniques at six weeks. These early, enhanced robotic-assisted THA results support surgeons using robotics with the goals of decreased patient pain, greater range of motion, and increased joint stability.

Keyphrases: additive manufacturing, porous, robotic assisted, total hip arthroplasty

In: Patrick Meere and Ferdinando Rodriguez Y Baena (editors). CAOS 2019. The 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery, vol 3, pages 206-209.

Links:	https://easychair.org/publications/paper/dVwq
	https://doi.org/10.29007/4kmb

BibTeX entry

@inproceedings{CAOS2019:Robotic_assisted_total_hip,
  author    = {Seth Jerabek and Russell Cohen and Alana Levine and Alice Cruz and Laura Scholl},
  title     = {Robotic-assisted total hip arthroplasty yields enhanced surgical and clinical outcomes compared to manual hip arthroplasty using the same implant system},
  booktitle = {CAOS 2019. The 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery},
  editor    = {Patrick Meere and Ferdinando Rodriguez Y Baena},
  series    = {EPiC Series in Health Sciences},
  volume    = {3},
  publisher = {EasyChair},
  bibsource = {EasyChair, https://easychair.org},
  issn      = {2398-5305},
  url       = {/publications/paper/dVwq},
  doi       = {10.29007/4kmb},
  pages     = {206-209},
  year      = {2019}}

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