Reduction in Operative Time After Implementation of Computer-Assisted Navigation in Direct Anterior Total Hip...

Computer-assisted navigation (CAN) in total hip arthroplasty (THA) is associated with improved component positioning accuracy. However, its impact on operative efficiency remains uncertain and may be influenced by the learning curve during adoption. This study evaluates the effect of a computerized hip navigation system on operative time and surgical complications.

We conducted a retrospective chart review of 300 consecutive direct anterior THAs by a single surgeon: 150 using conventional overlay, followed by 150 after implementation of CAN. After applying exclusion criteria, 292 cases remained. Demographic and perioperative variables were collected. Generalized linear modeling adjusted for covariates (body mass index, age, American Society of Anesthesiologists class) to assess relationship between surgical technique and operative time. Postoperative complications were compared between groups.

CAN was associated with significant reduction in operative time. Compared to conventional THA (covariate-adjusted mean: 47.63 minutes), operative time was 2.65 minutes shorter during the learning phase, identified via statistical analysis as the first 100 CAN cases. Post-learning phase, mean operative time further decreased to 40.42 minutes, 7.21 minutes less than conventional THA (P < .001). Body mass index was positively associated with increased operative time; age showed a modest inverse relationship. No significant difference in complication rates was observed between conventional and CAN groups (P = .54).

Implementation of CAN was associated with significantly decreased operative time after a brief learning curve, without an increase in complications. Findings support safe adoption of CAN in direct anterior THA and suggest enhanced operative efficiency, aligning with the demands of value-based care and increasing surgical volumes.