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Robotic-assisted versus conventional total hip arthroplasty: a three-year comparative analysis of patient-reported
Adarsh Annapareddy1, Tarun Jayakumar2, Vijay Krishna Adusumalli1
11-t1- Sunshine Bone and Joint Institute, KIMS-Sunshine Hospitals, Hyderabad, India.
Purpose:
Robotic-assisted total hip arthroplasty (RA-THA) has been shown to improve implant positioning accuracy; however, whether these advantages translate into superior patient-reported outcomes remains controversial. The purpose of this study was to compare functional outcomes and complication rates between robotic-assisted and manual total hip arthroplasty (M-THA) at a minimum of three years follow-up.
Methods:
This retrospective observational cohort study included consecutive patients undergoing primary THA between June 2020 and June 2022 at a single high-volume arthroplasty centre. Seventy-five patients underwent M-THA and 81 underwent RA-THA. The primary outcome was the Oxford Hip Score (OHS) at three years. Secondary outcomes included modified Harris Hip Score (mHHS), Hip Disability and Osteoarthritis Outcome Score for Joint Replacement (HOOS-Jr), Forgotten Joint Score (FJS), and complications including dislocation, infection, readmission, and reoperation.
Results:
A total of 156 patients were available for final analysis. The robotic cohort demonstrated significantly higher OHS (46.47 ± 2.98 vs. 45.01 ± 4.90; p = 0.016) and HOOS-Jr scores (94.82 ± 9.70 vs. 91.48 ± 10.51; p = 0.005). However, the observed differences did not exceed the reported minimal clinically important differences. No significant differences were observed in mHHS (p = 0.497) or FJS (p = 0.949). Complications occurred in 2.5% of RA-THA patients and 6.7% of M-THA patients (p = 0.262).
Conclusion:
Both robotic-assisted and manual THA provided excellent medium-term outcomes. Robotic-assisted THA demonstrated modest functional advantages and a trend toward lower complication rates, although these differences were not clinically meaningful. Larger prospective studies are required to determine whether improved accuracy translates into superior long-term outcomes and implant survivorship.