Clinical efficacy of robot-assisted total hip arthroplasty for developmental dysplasia of the hip: A meta-analysis.

Abstract

Objectives: The aim of this meta-analysis was to compare the clinical efficacy of robot-assisted total hip arthroplasty (R-THA) versus conventional total hip arthroplasty (C-THA) for the treatment of developmental dysplasia of the hip (DDH).

Materials and methods: Eligible articles published until May 2025 were searched from the Cochrane Library, Web of Science, PubMed, Embase, ScienceDirect, and Springer. Search terms included "robot-assisted", "developmental dysplasia of the hip", "total hip arthroplasty", using mean differences (MDs) and risk differences (RDs) as combined variables, and selecting 95% as the confidence interval (CI).

Results: Seven clinical studies with a total of 876 patients were finally included in this study. There were no significant differences between the two groups in terms of cup inclination (MD=0.07; 95% CI: -0.95 ~ 1.10; p=0.89), cup anteversion (MD=-4.02; 95% CI: -9.59 ~ 1.55; p=0.16), intraoperative bleeding (MD=11.25; 95% CI: -56.02 ~ 78.52; p=0.74), operative time (MD=3.03; 95% CI: -15.66 ~ 21.72; p=0.75), postoperative complications (dislocation [RD=-0.01; 95% CI: -0.03 ~ 0.01; p=0.26], deep infection [RD=0.01; 95% CI: -0.01 ~ 0.02; p=0.37] and nerve injury [RD=0.01; 95% CI: -0.01 ~ 0.03; p=0.56], revision/reoperation [RD=-0.00; 95% CI: -0.03 ~ 0.03; p=1.00], and absolute vertical distance of center of rotation [COR] [MD=-0.50; 95% CI: -1.07 ~ 0.06; p=0.08]). However, compared to the C-THA group, the R-THA group showed significantly higher Harris Hip Score (HHS) (MD=2.17, 95% CI: 0.11 ~ 4.22, p=0.04) and more accurate placement of the horizontal COR (MD=-0.77; 95% CI: -1.21 ~ -0.32; p=0.0008).

Conclusion: In the R-THA group, the accuracy of horizontal placement of the COR was moderately improved, and the postoperative HHS was higher than that in the C-THA group, although such differences might not be obviously perceived by patients. Additionally, no significant differences were found between the two groups in other surgery-related parameters and safety.