Xianzuo Zhang, Xianyue Shen, Rongwei Zhang, Mo Chen, Ruixiang Ma, Zian Zhang, Haining Zhang, Bo Yang, Chen Zhu
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引用次数: 0
Abstract
Background: The effectiveness of robot-assisted surgery remains contentious due to the lack of high-quality randomized controlled trials (RCTs) to elevate the level of evidence. We aimed to evaluate the postoperative radiographic outcomes of robot-assisted (RAS-THA) versus manual (M-THA) total hip arthroplasty.
Methods: This multicenter RCT was performed from March 1, 2021 to December 1, 2021. Patients were randomly assigned to routine M-THA or to RAS-THA that used the TRex-RS orthopedic joint surgical navigation system. The primary outcome was to compare the acetabular component orientation, femoral stem alignment, femoral canal fill ratio, and leg length discrepancy between RAS-THA and M-THA using postoperative radiography. Subgroup analyses of the two groups stratified by surgical approach, gender, and BMI were also conducted.
Results: Seventy-three participants were randomly allocated to the RAS-THA group, while seventy-two participants were assigned to the M-THA group. Compared to the M-THA group, the RAS-THA group exhibited less variability in the preoperative planning of the vertical center of rotation (VCOR; P < 0.001), demonstrated a significant advantage in femoral stem alignment (P = 0.004), and showed pronounced decreases in inequality and in the variability in leg length discrepancy (P < 0.001). There was no significant difference in the Lewinnek safe-zone ratio (P = 0.081) and the femoral canal fill ratio (P > 0.05) between the two groups. Further subgroup analysis also showed that the RAS-THA group had fewer horizontal center of rotation (HCOR) and leg length differences when stratified by surgical approach, gender, and overweight status.
Conclusion: This RCT found that, regardless of the surgical approach, gender, or body mass index, RAS-THA can effectively improve the postoperative VCOR and significantly reduce the variability of leg length difference. RAS-THA should be considered an effective method to enhance surgical precision by achieving less variability in challenging patients with leg length discrepancies.
期刊介绍：
The Journal of Orthopaedics and Traumatology, the official open access peer-reviewed journal of the Italian Society of Orthopaedics and Traumatology, publishes original papers reporting basic or clinical research in the field of orthopaedic and traumatologic surgery, as well as systematic reviews, brief communications, case reports and letters to the Editor. Narrative instructional reviews and commentaries to original articles may be commissioned by Editors from eminent colleagues. The Journal of Orthopaedics and Traumatology aims to be an international forum for the communication and exchange of ideas concerning the various aspects of orthopaedics and musculoskeletal trauma.
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