Conventional vs Robotic Arm Assisted Total Hip Arthroplasty (THA) Surgical Time, Transfusion rates, Length of Stay, Complications and Learning Curve

Abstract

Background: Total hip arthroplasty (THA) is increasingly more popular with our aging population. Robotic arm assisted THA uses patient specific information gathered from a pre-operative CT scan and correlation with intraoperative checkpoints to improve the accuracy and reproducibility of component positioning. Despite the various advantages robotic arm assisted THA can offer, there are still concerns regarding increased surgical time, technical complexity, complications and costs.Method: Retrospective review of a single surgeons’ last 45 conventional THA performed prior to changing to the robotic arm assisted system with the first 45 robotic arm assisted THA. Surgical time, Length of stay (LOS) in hospital, LOS in rehabilitation, transfusion rates and any complications were compared.Results: Average surgical time was 96.7 mins for the rob otic group and 84.9 mins for conventional group; however each robotic operation was approximately one minute shorter than the previous operation and the average time for the last 10 cases reduced to 82.9 mins. Compared to conventional THA there is no increased risk of complications or transfusions and interestingly there may be less chance of intraoperative acetabular fractures due to the single ream, minimal bone resection technique. LOS in the robotic group that did not go to rehabilitation was shorter by approximately 1 day and although statistically analyse for LOS in rehabilitation was not done due to small numbers there was a tendency for shorter LOS in the robotic group as well.Conclusion: This reduction in LOS, comparable surgical times and potential for less complications may outweigh the increased initial costs associated with the robotic system.