Early Patient-Reported Outcome Measures Following Computer Navigated Total Hip Arthroplasty: A Study From the
Ernest C Lourens1, Yuze Zhai2, Dylan Harries3
1Mount Gambier Hospital, Limestone Coast Local Health Network, Mount Gambier, South Australia, Australia.
Background:
Total hip arthroplasty (THA) is a well-established treatment for symptomatic hip osteoarthritis (OA). The use of computer navigation in THA aims to achieve the reconstruction of the joint more consistently and precisely. The aim of this study was to contrast patient-reported outcome measures (PROMs) for THA procedures with and without commercially available navigation technologies.
Methods:
Postoperative PROMs for primary THA procedures performed for OA between August 2018 and December 2022 and recorded in the Australian Orthopaedic Association National Joint Replacement Registry were analyzed. Procedures using computer navigation were compared to those using conventional instrumentation. Baseline patient characteristics and surgeon volume were subanalyzed. Multivariable regressions were used to compare postoperative PROMs.
Results:
There were 13,400 THA procedures for OA with PROMs recorded and 749 with navigation. The mean (SD) EuroQol-visual analog scales (EQ-VASs) scores for navigated cases were 67.3 (19.3) preoperatively and 81.7 (15.0) postoperatively, compared with 66.0 (20.3) and 80.5 (15.8) for the non-navigated group. Oxford Hip scores and patient-reported change were similar between groups. The change from preoperative to postoperative EQ-VAS and Oxford Hip score did not significantly differ between computer-navigated and non-navigated cases. After adjusting for patient and procedure factors, the use of computer navigation was associated with a higher rate of procedure satisfaction (rate ratio 1.03, 95% confidence interval 1.01 to 1.06, P = 0.02).
Conclusions:
While procedural satisfaction was marginally higher following navigated THA (P = 0.02), there were no statistically significant differences in the change in EQ-VAS or when comparing navigated with "non-navigated" approaches for primary THAs. Based on the reviewed national registry data for PROMS, we were unable to demonstrate clinically relevant evidence to support claims of superiority of non-navigated or navigated primary THAs. Further work, including similar comparisons with long-term follow-up, will be of value in elucidating if a true clinically relevant difference exists.
