Reduction in Operative Time After Implementation of Computer-Assisted Navigation in Direct Anterior Total Hip Arthroplasty With Consideration of Learning Curve

IF 2.1 Q3 ORTHOPEDICS

Arthroplasty Today Pub Date : 2026-06-01 Epub Date: 2025-11-13 DOI:10.1016/j.artd.2025.101892

Roy F. Small DO, Michelle Drouin PhD, Mindy Flanagan PhD, Manda Coupe BA, Jay Fiechter MD, Christopher N. Johnson DO

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引用次数: 0

Abstract

Background

Computer-assisted navigation (CAN) in total hip arthroplasty (THA) is associated with improved component positioning accuracy. However, its impact on operative efficiency remains uncertain and may be influenced by the learning curve during adoption. This study evaluates the effect of a computerized hip navigation system on operative time and surgical complications.

Methods

We conducted a retrospective chart review of 300 consecutive direct anterior THAs by a single surgeon: 150 using conventional overlay, followed by 150 after implementation of CAN. After applying exclusion criteria, 292 cases remained. Demographic and perioperative variables were collected. Generalized linear modeling adjusted for covariates (body mass index, age, American Society of Anesthesiologists class) to assess relationship between surgical technique and operative time. Postoperative complications were compared between groups.

Results

CAN was associated with significant reduction in operative time. Compared to conventional THA (covariate-adjusted mean: 47.63 minutes), operative time was 2.65 minutes shorter during the learning phase, identified via statistical analysis as the first 100 CAN cases. Post-learning phase, mean operative time further decreased to 40.42 minutes, 7.21 minutes less than conventional THA (P < .001). Body mass index was positively associated with increased operative time; age showed a modest inverse relationship. No significant difference in complication rates was observed between conventional and CAN groups (P = .54).

Conclusions

Implementation of CAN was associated with significantly decreased operative time after a brief learning curve, without an increase in complications. Findings support safe adoption of CAN in direct anterior THA and suggest enhanced operative efficiency, aligning with the demands of value-based care and increasing surgical volumes.

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考虑学习曲线的计算机辅助导航在直接前路全髋关节置换术中缩短手术时间。

背景：计算机辅助导航（CAN）在全髋关节置换术（THA）中与提高部件定位精度有关。然而，它对操作效率的影响仍然不确定，并可能受到采用过程中学习曲线的影响。本研究评估计算机化髋关节导航系统对手术时间和手术并发症的影响。方法：我们对同一位外科医生连续300例直接前路tha进行了回顾性图表回顾：150例使用常规覆盖，150例使用CAN。应用排除标准后，剩余292例。收集人口统计学和围手术期变量。广义线性模型校正协变量（体重指数、年龄、美国麻醉师学会等级），评估手术技术与手术时间之间的关系。比较两组术后并发症。结果：CAN与手术时间明显缩短相关。与常规THA相比（协变量调整平均值：47.63分钟），学习阶段手术时间缩短2.65分钟，经统计分析确定为前100例CAN病例。术后平均手术时间为40.42 min，较常规THA缩短7.21 min （P < 0.001）。体重指数与手术时间增加呈正相关；年龄表现出适度的反比关系。常规组与CAN组并发症发生率无显著差异（P = 0.54）。结论：在短暂的学习曲线后，CAN的实施与显著缩短手术时间相关，且未增加并发症。研究结果支持在直接前路THA中安全采用CAN，并建议提高手术效率，符合基于价值的护理需求和增加手术量。

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

Arthroplasty Today Medicine-Surgery

CiteScore

2.90

自引率

0.00%

发文量

258

审稿时长

40 weeks

期刊介绍： Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.