Low rates of dislocation and reoperation following robotic-assisted total hip arthroplasty for femoral neck fracture.

Abstract

Total hip arthroplasty (THA) is widely used for active, elderly patients with femoral neck fractures (FNF). Compared to THA for osteoarthritis, THA for FNF is associated with a higher incidence of dislocation and reoperation. Robotic assistance may improve component positioning and leg-length restoration in THA, but its use in FNF has not been described. The objective of this study was to assess the feasibility and perioperative outcomes of robotic-assisted THA (rTHA) for FNF. A retrospective review identified 93 patients undergoing 94 THAs for FNF from 2016 to 2023. 18 patients treated with MAKOplasty rTHA were compared to 76 non-rTHA. There were 69 (73%) women, the mean age was 71 years, and the mean follow-up was 3 years. There was no significant difference in operative time between rTHA and non-rTHA cohorts (100 vs. 108 minutes, <i>p</i> = 0.19), and sub-analysis of acute FNFs (< 6 weeks), showed no difference in the meantime from presentation to surgery (18 vs. 25 hours, <i>p</i> = 0.24). There was no significant difference in mean leg-length discrepancy (LLD) (<i>p</i> = 0.19), number of outliers for acetabular anteversion (<i>p</i> = 0.80), or inclination (<i>p</i> = 0.55). There were no postoperative dislocations or reoperations in the rTHA cohort, compared to 4 dislocations (5%) and 6 reoperations (8%) in the non-rTHA cohort (<i>p</i> = 1.00 and 0.59, respectively). In this series of THA for FNF, robotic assistance did not significantly delay the time to surgery or increase the operative time compared to non-rTHA. At a mean follow-up of 3 years, there were no postoperative dislocations or reoperations in the rTHA cohort.