Robotic‐arm assisted versus manual total hip arthroplasty: Systematic review and meta‐analysis of radiographic accuracy

• Published in: The international journal of medical robotics + computer assisted surgery Vol. 17; no. 6; pp. e2332 - n/a
• Main Authors: Emara, Ahmed K., Samuel, Linsen T., Acuña, Alexander J., Kuo, Andy, Khlopas, Anton, Kamath, Atul F.
• Format: Journal Article
• Language: English
• Published: Hamilton Wiley Subscription Services, Inc 01-12-2021
• Subjects: Biomedical materials; Femoral components; implant placement; Joint replacement surgery; Joint surgery; Meta-analysis; Orthopaedic implants; radiographic outcomes; robotic‐arm assisted total hip arthroplasty; semi‐active robotic systems; systematic review
• ISSN: 1478-5951; 1478-596X
• DOI: 10.1002/rcs.2332

Background
We systematically reviewed the radiological outcomes of studies comparing robotic‐assisted (RA‐THA) and manual total hip arthroplasty (mTHA).
Methods
The PubMed, Embase, and Cochrane databases were queried from 1994‐2021 for articles comparing radiographic outcomes between RA‐THA and mTHA cohorts. A meta‐analysis was conducted whenever sufficient data was present for common outcomes.
Results
Our analysis included 20 articles reporting on 4140 patients (RA‐THA: n = 1228; mTHA: n = 2912). No differences were demonstrated for acetabular inclination or anteversion. However, RA‐THA demonstrated higher rates of cup orientation within the Lewinnek and Callanan safe zones, improved femoral stem alignment, and lower global offset difference (GOD) and limb length discrepancy (all p‐values <0.05). Superior femoral canal fill and combined offset were seen among RA‐THA patients.
Conclusion
Our review found that the use of RA‐THA yields superior radiographic outcomes compared to mTHA counterparts. This information can inform healthcare systems considering investing in and implementing these technologies.