A comparison between robotic-assisted and manual implantation of cementless total hip arthroplasty.

Abstract

The benefits of robotic techniques for implanting femoral components during THA are still controversial. The purpose of this study was to prospectively compare the results and complications of robotic-assisted and hand-rasping stem implantation techniques. The minimum followup was 5 years (mean, 67 months; range, 60-85 months). One hundred forty-six primary THAs on 130 patients were included in this study. Robot-assisted primary THA was performed on 75 hips and a hand-rasping technique was used on 71 hips. At 2 and 3 years postoperatively, the Japanese Orthopaedic Association (JOA) clinical score was slightly better in the robotic-assisted group. At 5 years followup, however, the differences were not significant. Postoperative limb lengths of the robotic-milling group had significantly less variance than the hand-rasping group. At 2 years postoperatively, there was significantly more stress shielding of the proximal femur in the hand-rasping group; this difference was more significant 5 years postoperatively. Substantially more precise implant positioning seems to have led to less variance in limb-length inequality and less stress shielding of the proximal femur 5 years postoperatively. Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.