Robotic-assisted total hip arthroplasty utilizing a fluoroscopy-guided system resulted in improved intra-operative efficiency relative to a computerized tomography-based platform

• Published in: Journal of robotic surgery Vol. 17; no. 6; pp. 2841 - 2847
• Main Authors: Ong, Christian B., Buchan, Graham B. J., Hecht II, Christian J., Lawrie, Charles M., DeCook, Charles A., Sculco, Peter K., Kamath, Atul F.
• Format: Journal Article
• Language: English
• Published: London Springer London 01.12.2023; Springer Nature B.V
• Subjects: Biomedical materials; Body mass index; Computed tomography; Cost control; Economic justification; Efficiency; FDA approval; Fluoroscopy; Hip; Joint replacement surgery; Medical personnel; Medicine; Medicine & Public Health; Minimally Invasive Surgery; Necrosis; Orthopaedic implants; Osteoarthritis; Patients; Registration; Rheumatoid arthritis; Robotic surgery; Software; Surgeons; Surgery; Tomography; Urology; Variables; White people; Workflow; United States > US; Kalamazoo Michigan; Operative Time; Arthroplasty; Efficiency; Hip; Robotic-Assisted Surgery
• ISSN: 1863-2491; 1863-2483; 1863-2491
• DOI: 10.1007/s11701-023-01723-7

Robotic-assisted total hip arthroplasty (THA) using a computerized-tomography (CT) based workflow increases surgical time relative to traditional manual technique. The purpose of this investigation was to compare the intra-operative efficiencies of two robotic THA systems: a fluoroscopy-based platform (FL-RTHA) and a contemporary, CT-based (CT-RTHA) platform. A review of 107 consecutive FL-RTHA and 159 CT-RTHA primary, direct anterior approach (DAA) THA procedures was conducted. All cases were performed by one of two surgeons operating at the same institution, for a pre-operative diagnosis of osteoarthritis, avascular necrosis, or rheumatoid arthritis. Primary outcome variables included averages and consistencies (variances) for surgical times and operating room (OR) times. A secondary outcome was to quantify the duration of robot-active phases in the FL-RTHA workflow. The FL-RTHA cohort experienced shorter surgical times (38.71 min ± 7.00 vs. 75.33 min ± 11.38; p < 0.001) and OR times (101.35 min ± 12.22 vs. 156.74 min ± 17.79; p < 0.001) compared to the CT-RTHA cohort. Surgical times and OR times were both more consistent in the FL-RTHA cohort compared to the CT-RTHA cohort (p < 0.001). Patients who underwent DAA THA with the assistance of a fluoroscopy-based robotic system experienced shorter and more consistent surgical times and OR times compared to patients who underwent similar DAA THA procedures with a contemporary, CT-based robotic platform.