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Dislocation Rates Between Manual and Robotic-Assisted Total Hip Arthroplasty Using the Posterolateral Approach
Alexander K Hahn1, Jordan A Bauer, Martinus Megalla
1From the Department of Orthopaedic Surgery, University of Connecticut, Farmington, CT (Hahn, Bauer, and Megalla), and the Connecticut Joint Replacement Institute, Hartford, CT (Grosso).
The Journal of the American Academy of Orthopaedic Surgeons
|August 4, 2025
Summary
Robotic-assisted total hip arthroplasty (THA) showed no significant difference in 90-day dislocation rates compared to manual THA. This finding applies to high-volume surgeons using the posterolateral approach.
Area of Science:
- Orthopedic Surgery
- Robotics in Medicine
- Arthroplasty Research
Background:
- Dislocation is a significant risk following total hip arthroplasty (THA), occurring in approximately 2% of cases.
- The posterolateral (PL) approach, while common, poses concerns for implant stability due to posterior soft tissue disruption.
- Robotic assistance in THA has shown potential for improved implant positioning, but its impact on clinical outcomes requires further evaluation.
Purpose of the Study:
- To compare the 90-day dislocation rates between robotic-assisted and conventional manual primary total hip arthroplasty (THA) performed via the posterolateral (PL) approach.
- To evaluate the influence of robotic assistance on complication rates and patient-reported outcomes in THA.
- To assess the learning curve and efficiency of robotic-assisted THA compared to manual techniques.
Main Methods:
- A retrospective analysis of 2,548 primary THA cases performed via the PL approach between 2014 and 2023 by two high-volume surgeons.
- Comparison of 1,727 manual THA cases with 821 robotic-assisted THA cases.
- Statistical analysis using Student t-test for numerical data and chi-square analysis for categorical data, with a significance level of P < 0.05.
Main Results:
- No statistically significant difference in 90-day dislocation rates was observed between the manual (0.4%) and robotic-assisted (0.4%) THA groups (P = 0.88).
- Total complication rates were also similar between the groups (3.4% manual vs. 2.2% robotic-assisted, P = 0.092).
- Robotic-assisted THA resulted in a longer average surgical time (88 minutes) compared to manual THA (74 minutes).
Conclusions:
- For high-volume surgeons utilizing the posterolateral approach, robotic assistance does not significantly alter the 90-day dislocation risk in primary total hip arthroplasty.
- The study indicates comparable clinical outcomes regarding dislocation and overall complications between manual and robotic-assisted THA in this specific surgical context.
- Further research may be warranted to explore the long-term benefits and cost-effectiveness of robotic assistance in THA.
