Computer Navigation Assisted Total Hip Arthroplasty: Use and Outcomes Compared with Conventional Technique

Abstract

Computer-assisted surgery (CAS) for total hip arthroplasty (THA) was developed to improve the accuracy of component positioning. There is insufficient evidence on CAS THA in terms of early postoperative outcomes and complications. The aim of this study is to determine the time-related trends in computer navigation use and to compare outcomes to conventional technique. The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database containing primary THAs from 2008 to 2015 was retrospectively analyzed. Demographics, operative time, postoperative transfusions, hospital length of stay (LOS), wound complications, early reoperation, and readmissions were compared between CAS THA and traditional THA using univariate and multivariable regression analyses. The percent use of navigation in THA within the NSQIP database shows an increasing trend. There were more smokers and patients with higher American Society of Anesthesiologists ratings (p < 0.011) in the traditional THA group. According to multivariable regression, CAS THA was associated with lower postoperative transfusion rate and shorter LOS, but longer operative time (p < 0.001 for all) than traditional THA. Similarly, superficial infections were also lower in that group after controlling confounders (p = 0.028). There were no differences in overall infections, wound dehiscence, return to the operating room, or readmissions. CAS THA appears to be increasingly used over time within this database and is associated with lower transfusion rates, superficial infections, and shorter LOS. However, it may not afford any major advantages in operative time, overall infection rate, early return to the operating room, or early readmissions. These findings should be interpreted in light of potential long-term benefits that may be associated with CAS THA.

Keywords

computer navigation - robotic surgery - total hip arthroplasty outcomes

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