Does Robotic Assistance Increase the Likelihood of Achieving the Minimal Clinically Important Improvement Following Total Hip Arthroplasty? Findings From a Propensity Score Matched Analysis of 1,364 Procedures.

Abstract

Robotic-assisted total hip arthroplasty (rTHA) is associated with improved component positioning compared to manual THA (mTHA). However, its impact on achieving the minimal clinically important difference (MCID) in patient-reported outcomes remains unclear. This study compared rates of MCID for improvement (MCID-I), MCID for worsening (MCID-W), and complication rates between rTHA and mTHA. We performed a retrospective analysis of 341 rTHAs, matched 1:3 by propensity score to 1,023 mTHAs based on age, sex, body mass index, and Charlson Comorbidity Index. All THAs were performed between 2016 and 2022. Patient-reported outcomes included Patient-Reported Outcomes Measurement Information System (PROMIS) global physical, PROMIS global mental, PROMIS physical function short form 10a, and the Hip Disability and Osteoarthritis Outcome Score-physical function short form. We compared the rates of MCID-I and MCID-W between rTHA and mTHA at one year postoperatively, as well as 90-day complication rates and 2-year revision-free survival. For Hip Disability and Osteoarthritis Outcome Score-physical function short form, MCID-I rates were similar between mTHA and rTHA (85.3 versus 80.3%; P = 0.063), as were MCID-W rates (5.2 versus 7.6%; P = 0.16). Rates of MCID-I and MCID-W for PROMIS global physical, PROMIS global mental, and PROMIS physical function short form 10a were also comparable between the groups (all P > 0.05). Additionally, no significant differences were found in 90-day readmission rates (mTHA: 8.3 versus rTHA: 8.5%; P = 0.67) or 2-year revision-free survival (98.5% for both groups; P = 0.99). Robotic-assisted THA and mTHA have similar rates of clinically important improvements, complications and revision-free survival. Both approaches demonstrate excellent outcomes at one year. Further research should investigate long-term differences between rTHA and mTHA.