10-Year Functional Outcomes Following Robotic-Assisted Total Hip Arthroplasty: A Case Series.

Abstract

Robotic-assisted total hip arthroplasty (rTHA) has been shown to assist with precision in component placement. However, limited evidence exists evaluating its effects on minimum 10-year clinical outcomes. The purpose of this study was to report the minimum 10-year clinical outcomes in a case series of patients who underwent rTHA. Prospectively collected data from patients who underwent primary rTHA between June 2011 and April 2015 were analyzed. Patients who had a complete minimum 10-year follow-up, including radiographs and validated patient-reported outcomes (PROs), were included. A total of 215 hips met the inclusion criteria. The PROs included the Harris Hip Score (HHS), Hip Disability and Osteoarthritis Outcome Score-Joint Replacement (HOOS-JR), Forgotten Joint Score-12 (FJS-12), visual analog scale (VAS) pain, and patient satisfaction. Radiographic assessment included acetabular cup inclination, version, leg-length discrepancy, and cup placement relative to the Lewinnek and Callanan safe zones. At final follow-up, patients reported excellent outcomes, with mean HHS 93.0 ± 12.6, HOOS-JR 89.1 ± 16.1, FJS-12 85.2 ± 22.4, VAS pain 1.0 ± 1.9, and satisfaction 9.1 ± 1.8. The high FJS-12 score reflects that patients rarely or almost never thought about their hip in daily life. There were six revisions (2.8%): one for aseptic loosening (0.5%), one for leg-length discrepancy (0.5%), and four for acute postoperative infection (1.9%). Survivorship free of revision was 97.2% at 10 years. Radiographic analysis demonstrated that 91.1% of cups were within the Lewinnek safe zone and 87.4% within the Callanan safe zone. Notably, there were no cases of instability or dislocation. Robotic-assisted primary THA was associated with a high degree of accuracy in component placement and durable clinical outcomes with high patient satisfaction and low revision rates at a minimum 10-year follow-up.