Patient-reported outcome differences for navigated and robot-assisted total hip arthroplasty frequently do not achieve clinically important differences: a systematic review

IF 1.3 4区 医学 Q3 ORTHOPEDICS
Kyle W Lawrence, Vinaya Rajahraman, Morteza Meftah, Joshua C Rozell, Ran Schwarzkopf, Armin Arshi
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引用次数: 0

Abstract

Introduction:Total hip arthroplasty (THA) using computer-assisted navigation (N-THA) and robot-assisted surgery (RA-THA) has been increasingly adopted to improve implant positioning and offset/leg-length restoration. Whether clinically meaningful differences in patient-reported outcomes (PROMs) compared to conventional THA (C-THA) are achieved with intraoperative technology has not been established. This systematic review aimed to assess whether published relative PROM improvements with technology use in THA achieved minimal clinically important differences (MCIDs).Methods:PubMed/MEDLINE/Cochrane Library were systematically reviewed for studies comparing PROMs for primary N-THA or RA-THA with C-THA as the control group. Relative improvement differences between groups were compared to established MCID values. Reported clinical and radiographic differences were assessed. Review of N-THA and RA-THA literature yielded 6 ( n = 2580) and 10 ( n = 2786) studies, respectively, for analyses.Results:Statistically significant improvements in postoperative PROM scores were reported in 2/6 (33.3%) studies comparing N-THA with C-THA, though only 1 (16.7%) reported clinically significant relative improvements. Statistically significant improvements in postoperative PROMs were reported in 6/10 (60.0%) studies comparing RA-THA and C-THA, though none reported clinically significant relative improvements. Improved radiographic outcomes for N-THA and RA-THA were reported in 83.3% and 70.0% of studies, respectively. Only 1 study reported a significant improvement in revision rates with RA-THA as compared to C-THA.Conclusions:Reported PROM scores in studies comparing N-THA or RA-THA to C-THA often do not achieve clinically significant relative improvements. Future studies reporting PROMs should be interpreted in the context of validated MCID values to accurately establish the clinical impact of intraoperative technology.
导航和机器人辅助全髋关节置换术的患者报告结果差异往往达不到临床重要差异:系统性综述
导言:使用计算机辅助导航(N-THA)和机器人辅助手术(RA-THA)的全髋关节置换术(THA)已被越来越多地采用,以改善植入物定位和偏移/腿长恢复。与传统的 THA(C-THA)相比,术中技术是否能在患者报告结果(PROMs)方面实现有临床意义的差异尚未确定。本系统性综述旨在评估已发表的在THA中使用技术后PROM的相对改善是否达到了最小临床意义差异(MCIDs)。方法:系统性综述了PubMed/MEDLINE/Cochrane图书馆中以C-THA为对照组,比较初治N-THA或RA-THA的PROMs的研究。将各组间的相对改善差异与既定的 MCID 值进行比较。还评估了所报告的临床和放射学差异。结果:2/6(33.3%)项比较N-THA和C-THA的研究报告了术后PROM评分有统计学意义的改善,但只有1项(16.7%)报告了有临床意义的相对改善。6/10(60.0%)项比较 RA-THA 和 C-THA 的研究报告了术后 PROMs 有统计学意义的明显改善,但没有一项报告了有临床意义的相对改善。分别有 83.3% 和 70.0% 的研究报告称,N-THA 和 RA-THA 的放射学结果有所改善。结论:在对N-THA或RA-THA与C-THA进行比较的研究中,所报告的PROM评分往往不能达到有临床意义的相对改善。未来报告PROMs的研究应结合经过验证的MCID值进行解释,以准确确定术中技术的临床影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
HIP International
HIP International 医学-整形外科
CiteScore
4.20
自引率
0.00%
发文量
70
审稿时长
2 months
期刊介绍: HIP International is the official journal of the European Hip Society. It is the only international, peer-reviewed, bi-monthly journal dedicated to diseases of the hip. HIP International considers contributions relating to hip surgery, traumatology of the hip, prosthetic surgery, biomechanics, and basic sciences relating to the hip. HIP International invites reviews from leading specialists with the aim of informing its readers of current evidence-based best practice. The journal also publishes supplements containing proceedings of symposia, special meetings or articles of special educational merit. HIP International is divided into six independent sections led by editors of the highest scientific merit. These sections are: • Biomaterials • Biomechanics • Conservative Hip Surgery • Paediatrics • Primary and Revision Hip Arthroplasty • Traumatology
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