Robotics‐assisted versus conventional manual approaches for total hip arthroplasty: A systematic review and meta‐analysis of comparative studies

Abstract

Background Several studies have compared robotics‐assisted (RA) and conventional manual (CM) approaches for total hip arthroplasty (THA), but their results are controversial. Methods A literature search was conducted for controlled clinical trials (CCTs) comparing the clinical efficacy of the RA and CM approaches for THA and published between August 1998 and August 2018. The obtained data were analyzed using the statistical software Review Manager 5.3. Results Fourteen articles were included in the meta‐analysis, which revealed that the RA group had less intraoperative complications, better cup angle, and more cases of cup placement in the safe zone than the CM group. However, the operation time required for the CM group was less than that required for the RA group. Moreover, postoperative complications (eg, dislocation and revision surgery) were less frequent in the CM group than in the RA group. However, the two groups had similar functional scores, total number of complications, and rate of occurrence of limb length discrepancy. Conclusion Compared with the CM approach, the RA approach yields better radiological outcomes and fewer intraoperative complications in THA, but similar functional scores.

Current concepts in robotic total hip arthroplasty

“…Similarly, in a prospective matched cohort of 50 patients undergoing conventional manual THA and 25, a Mako TM robotic-arm assisted THA, Kayani et al [50] also reported improved accuracy placement of the cup according to the Lewinnek and Callanan safe zone. Recent studies reported similar results [51][52][53][54][55][56].…”

“…However, there was no difference between the different groups considering the technical problems (1 case was secondary to poor fixation of the femoral landmark in group A, 1 case of bad impaction of the cup in group A) or complications. In a recent meta-analysis, Han et al [53] reported a significantly increased operating time of robotic procedures compared to the conventional techniques. This learning curve has to integrate sometimes the adjustment of surgeon practice with the use of a new design of the implant.…”

Portable Accelerometer-Based Navigation System for Cup Placement of Total Hip Arthroplasty: A Prospective, Randomized, Controlled Study

“…Xu et al [16] reported operation time was increased 19.2 minutes by the use of the large console navigation system in their meta-analysis. And recent meta-analysis reported operation time was increased 20.72 minutes by the use of the robotic system [29]. Recently, one study reported the results of HipAlign in the supine position [23].…”

In vivo kinematic analysis of patients with robotic‐assisted total hip arthroplasty during gait at 1‐year follow‐up

“…These results suggested that gait asymmetry was not fully eliminated by either robotic arm–assisted or freehand THA. A previous study indicated that robotic arm–assisted THA is associated with better radiological outcomes and fewer intraoperative complications, but similar functional scores …”

“…A previous study indicated that robotic arm-assisted THA is associated with better radiological outcomes and fewer intraoperative complications, but similar functional scores. 27 Internal rotation gait has been previously reported in children with excessive femoral anteversion as an adaptation to decreased abductor capacity. 28 Higher internal rotation of the native hip was also found in patients with groin pain and impingement and correlated with bony anatomy in the axial plane.…”