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Opioid consumption during hospitalisation among robotic-assisted, computer-assisted, and manual total hip

Periklis Giannakis1,2, Juliet E Rowe1, Renee Ren1

  • 1Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA.

BJA Open
|February 13, 2026
PubMed

Insights

Computer-assisted and robotic-assisted total hip arthroplasty (THA) showed lower opioid consumption than manual THA, particularly on postoperative day 1. These findings suggest potential benefits of technology-assisted THA for pain management.

Area of Science:

  • Orthopedic Surgery
  • Pain Management
  • Health Informatics

Background:

  • Opioid consumption is a significant concern following total hip arthroplasty (THA).
  • Different surgical approaches, including manual (MA-THA), computer-assisted (CA-THA), and robotic-assisted (RA-THA), may influence postoperative pain and opioid use.

Purpose of the Study:

  • To compare total opioid consumption during hospitalization across MA-THA, CA-THA, and RA-THA.
  • To evaluate the impact of surgical technique on opioid use on specific postoperative days.

Main Methods:

  • Retrospective cohort study using the Premier Healthcare database (2016-2023).
  • Analysis of 584,578 patients undergoing unilateral elective THA.
  • Two-part mixed-effects models assessing opioid use (yes/no) and consumption among users.

Main Results:

  • CA-THA was associated with lower odds of any opioid use than MA-THA (OR, 0.87).
  • RA-THA showed higher odds of any opioid use than CA-THA (OR, 1.22).
  • Both CA-THA and RA-THA were linked to 2% lower total opioid consumption than MA-THA among users. Significant reductions were noted on postoperative day 1 for both CA-THA and RA-THA compared to MA-THA.

Conclusions:

  • Technology-assisted THA (CA-THA and RA-THA) is associated with reduced opioid consumption compared to MA-THA, especially in the early postoperative period.
  • While not clinically significant enough to alter decision-making, the observed differences may relate to anesthetic techniques offering improved immediate postoperative pain relief.
Abstract

Keywords:
computer assistedopioidspostsurgical painrobotic assistedtotal hip replacement

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