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
