Clinical, functional, and radiological outcomes of robotic assisted versus conventional total hip arthroplasty: a systematic review and meta-analysis of randomized controlled trials.
Pakpoom RuangsomboonOnlak RuangsomboonKhabab OsmanDaniel PincusRaman MundiSebastian TomescuBheeshma RaviHarman ChaudhryPublished in: Journal of robotic surgery (2024)
This systematic review of randomized controlled trials (RCTs) aims to compare important clinical, functional, and radiological outcomes between robotic-assisted total hip arthroplasty (RATHA) and conventional total hip arthroplasty (COTHA) in patients with hip osteoarthritis. We identified published RCTs comparing RATHA with COTHA in Ovid MEDLINE, EMBASE, Scopus, and Cochrane Library. Two reviewers independently performed study screening, risk of bias assessment and data extraction. Main outcomes were major complications, revision, patient-reported outcome measures (PROMs), and radiological outcomes. We included 8 RCTs involving 1014 patients and 977 hips. There was no difference in major complication rate (Relative Risk (RR) 0.78; 95% Confidence Interval (CI) 0.22 to 2.74), revision rate (RR 1.33; 95%CI 0.08 to 22.74), and PROMs (standardized mean difference 0.01; 95%CI - 0.27 to 0.30) between RATHA and COTHA. RATHA resulted in little to no effects on femoral stem alignment (mean difference (MD) - 0.57 degree; 95%CI - 1.16 to 0.03) but yielded overall lower leg length discrepancy (MD - 4.04 mm; 95%CI - 7.08 to - 1.0) compared to COTHA. Most combined estimates had low certainty of evidence mainly due to risk of bias, inconsistency, and imprecision. Based on the current evidence, there is no important difference in clinical and functional outcomes between RATHA and COTHA. The trivial higher radiological accuracy was also unlikely to be clinically meaningful. Regardless, more robust evidence is needed to improve the quality and strength of the current evidence.PROSPERO registration: the protocol was registered in the PROSPERO database (CRD42023453294). All methods were carried out in accordance with relevant guidelines and regulations.
Keyphrases
- total hip arthroplasty
- patient reported outcomes
- systematic review
- patient reported
- randomized controlled trial
- newly diagnosed
- total knee arthroplasty
- emergency department
- molecular dynamics
- ejection fraction
- meta analyses
- prognostic factors
- metabolic syndrome
- chronic kidney disease
- skeletal muscle
- risk factors
- adipose tissue
- deep learning
- machine learning
- insulin resistance
- electronic health record