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Postoperative Complications and Readmission Rates in Robotic-Assisted and Manual Total Hip Arthroplasty: A Large,
Cole Howell1, Sietske Witvoet2, Laura Scholl3
1Albany Medical College, Albany, NY.
Objective:
This study aims to compare 90-day postoperative complications, readmissions, and emergency department (ED) visits between robotic-assisted (RA-THA) and manual (M-THA) total hip arthroplasty.
Methods:
A retrospective review of a multi-hospital database identified primary total hip arthroplasty patients between January 2016 and December 2021. The cohorts were 1-to-1 matched based on patient sex, age, and body mass index resulting in 8033 patients in each cohort (N = 16,066). Odds of 90-day revisits, readmission with >23 hours of observation, and ED visits were compared between cohorts. Complications reported during revisits and readmission were classified according to the Clinical Classification Software schema, using the International Classification of Diseases, 10th Revision codes, and compared using mixed-effect models.
Results:
This study found an overall 90-day revisit rate of 8.3%. RA-THA was associated with significantly reduced odds of revisit within 90 days [odds ratio (OR): 0.71, 95% CI: 0.58-0.89, P = 0.002] and readmissions with >23 hours of observation (OR: 0.61, 95% CI: 0.48-0.77, P < 0.001). RA-THA patients had fewer readmissions with >23 hours of observation due to dislocations (RA-THA: 0.09%; M-THA: 0.39%, P < 0.001), surgical site infections (RA-THA: 0.04%; M-THA: 0.20%, P = 0.004), and wound infections/cellulitis (RA-THA: 0.01%; M-THA: 0.11%, P = 0.021). No difference in ED visits was observed between cohorts (OR: 0.92, 95% CI: 0.77-1.09, P = 0.3). RA-THA patients had more ED visits for dyspnea without pulmonary embolism (RA-THA: 0.20%; M-THA: 0.06%, P = 0.03).
Conclusion:
RA-THA showed significantly lower odds of overall 90-day revisit rates and readmissions with >23 hours of observation, most notably for readmissions due to dislocation and surgical site infection/wound infections. There was no significant difference in the odds of ED visits between cohorts.
