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Robotic-assisted Total Hip Arthroplasty May Reduce the Risk of Complications in Patients Younger than 35

7 pagesPublished: October 27, 2019

Abstract

Purpose: In younger patients during total hip arthroplasty, the presence of morphologic deformities, previous surgeries, and retained hardware, can pose technical challenges making reconstruction difficult. The purpose of our study is to assess the outcome of robotic-assisted THA compared to conventional THA in patients younger than 35 years old.

Methods: A retrospective analysis of 123 patients younger than 35 years old that underwent primary unilateral THA between January 2013 and April 2018 was conducted. Patients were divided into two cohorts: (1) robotic-assisted THA and (2) conventional-THA (c-THA). Demographics, operative details, and postoperative outcomes were carefully studied. Radiographic analysis included measurement of postoperative acetabular anteversion and inclination angles as well as postoperative leg length discrepancies. Chi square and unpaired student t-tests were performed for all categorical and continuous variables, respectively.

Results: Of the total 123 patients, 30 patients (32 hips) were in the robotic-THA cohort, and 93 patients (100 hips) were in the conventional-THA cohort. Patients in the robotic-THA cohort were younger (26.6±6.2 vs. 29.0±5.3; p=0.03), had a higher mean BMI (29.8±8.2 vs. 25.7±5.9; p=0.03) at surgery. The most common indication for THA was DDH and osteonecrosis. The acetabular component was positioned within Lewinnek’s safe zone more often in the robotic-THA cohort compared to the c-THA cohort (94% vs 65%; p<0.01) (Figures 1 and 2). Leg length discrepancies were similar between both cohorts. Patients in the c-THA group were more likely to experience clinically significant higher rates of dislocation (2.9% vs. 0), revision (6.8%), any postoperative complication (7.8%), and 90-day readmission (2.9) following THA.

Conclusion: Robotic THA can help improve outcomes in younger THA recipients. Future studies with larger cohorts and longer follow-up times should evaluate outcomes in this historically technically demanding patient population.

Keyphrases: complex total hip arthroplasty, outcomes, robotic 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 282--288

Links:
BibTeX entry
@inproceedings{CAOS2019:Robotic_assisted_Total_Hip_Arthroplasty,
  author    = {David Novikov and Tyler Luthringer and Zlatan Cizmic and Siddharth Mahure and Nima Eftekhary and Roy Davidovitch and Jonathan Vigdorchik},
  title     = {Robotic-assisted Total Hip Arthroplasty May Reduce the Risk of Complications in Patients Younger than 35},
  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},
  pages     = {282--288},
  year      = {2019},
  publisher = {EasyChair},
  bibsource = {EasyChair, https://easychair.org},
  issn      = {2398-5305},
  url       = {https://easychair.org/publications/paper/Fxm1},
  doi       = {10.29007/vn42}}
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