Imageless computer-assisted versus conventional total hip arthroplasty: one surgeon's initial experience.

Area of Science:

• Orthopedic surgery
• Surgical technology
• Medical device evaluation

Background:

• Computer-assisted surgery (CAS) is proposed to enhance component positioning in total hip arthroplasty (THA).
• Debate exists regarding the operative risks and economic implications of CAS.
• Evaluating CAS efficacy against conventional instrumentation is crucial for clinical adoption.

Purpose of the Study:

• To compare radiographic outcomes, operative efficiency, cost, and midterm functional results of THA performed with CAS versus conventional instrumentation.
• To determine if CAS provides superior accuracy in component placement.
• To assess the overall value proposition of CAS in THA.

Main Methods:

• Retrospective analysis of 126 lower-extremities in the CAS series and 215 in the conventional THA series.
• Comparison of radiographic outcomes, including inclination angle and leg length discrepancy.
• Evaluation of operative efficiency (operating room times, blood loss) and midterm functional outcomes (Harris Hip Score).

Main Results:

• No significant difference in Harris Hip Score or leg length discrepancy between CAS and conventional THA.
• Increased inclination angle, blood loss, and operating room times were observed with CAS.
• CAS did not demonstrate improved accuracy in component placement compared to conventional methods.

Conclusions:

• CAS does not offer advantages in THA component accuracy over conventional instrumentation.
• CAS is associated with increased costs and potential operative risks without functional benefits.
• Conventional methods remain a cost-effective and safe approach for THA component placement.