Opioid Use After Robotic-Assisted Versus Conventional Total Hip Arthroplasty: A National Database Analysis

Area of Science:

• Orthopedic Surgery
• Pain Management
• Medical Technology

Background:

• Opioid use after total hip arthroplasty (THA) is a significant concern.
• Comparing robotic-assisted THA with conventional THA is crucial for understanding differences in postoperative opioid consumption.
• Investigating the incidence of new, persistent opioid use is essential for long-term patient outcomes.

Purpose of the Study:

• To test the hypothesis that robotic-assisted THA is not associated with differences in postoperative opioid use compared to conventional THA.
• To evaluate the association between robotic-assisted THA and the incidence of new, persistent opioid use.
• To provide evidence supporting the adoption of robotic-assisted THA for opioid reduction.

Main Methods:

• A large national administrative database was used to identify patients aged 50+ undergoing primary THA.
• Patients with specific exclusions (hip fractures, malignancy, infection, prior opioid use) were removed.
• Multivariable logistic regression analyzed the association between robotic-assisted THA and new, persistent opioid use, adjusting for covariates.

Main Results:

• Robotic-assisted THA was linked to lower mean total morphine milligram equivalents (MMEs) filled postoperatively (452.2 vs 517.1; P<.001).
• A lower mean MMEs per patient per day was observed with robotic-assisted THA (71.53 vs 74.64; P<.001).
• Patients undergoing robotic-assisted THA showed decreased odds of new, persistent opioid use (adjusted odds ratio, 0.82).

Conclusions:

• Robotic-assisted THA is associated with reduced postoperative opioid consumption compared to conventional THA.
• The incidence of new, persistent opioid use is lower in patients who undergo robotic-assisted THA.
• The findings support the use of robotic-assisted THA as a strategy to decrease overall opioid utilization in hip arthroplasty patients.