Surgeon Experience Influences Posterior Approach Total Hip Arthroplasty Dislocation Risk, But It Is Mitigated by...

Area of Science:

• Orthopedic Surgery
• Surgical Technology
• Patient Safety

Background:

• Dislocation is a frequent complication following total hip arthroplasty (THA).
• The impact of surgeon experience on dislocation rates is not well-established.
• This study investigates surgeon experience and enabling technology's role in THA dislocation.

Purpose of the Study:

• To compare dislocation rates between early-career and experienced surgeons in THA.
• To evaluate if computer navigation (CN) or robotic assistance (RA) mitigates dislocation risk for early-career surgeons.
• To analyze the influence of surgical approach (posterior vs. direct anterior) on dislocation rates.

Main Methods:

• Retrospective review of 5,516 primary THAs.
• Surgeons categorized as early-career (<5 years) or experienced (≥5 years).
• Multivariate logistic regression to identify factors associated with dislocation.

Main Results:

• Posterior approach (PA) THA had higher dislocation rates than direct anterior approach (DAA) THA (1.7% vs. 0.5%).
• Early-career surgeons had higher dislocation rates with manual PA THA (4.5%) compared to experienced surgeons (1.2%).
• Robotic assistance (RA) for early-career surgeons in PA THA reduced dislocation rates to 0.3%, comparable to experienced surgeons and DAA THA.

Conclusions:

• Early-career surgeons face increased dislocation risk with manual posterior approach THA.
• Robotic assistance (RA) effectively lowers dislocation risk for early-career surgeons performing PA THA.
• RA enables early-career surgeons to achieve dislocation rates similar to experienced surgeons and those using the DAA approach.