A Comparison of Component Positioning Between Fluoroscopy-Assisted and Robotic-Assisted Total Hip Arthroplasty

Background: This single-surgeon retrospective study examined a consecutive series of direct anterior approach total hip arthroplasties (THAs). Differences for the accuracy of acetabular component placement, leg length discrepancy, femoral offset, and absolute global offset difference were measured for patients who underwent hip replacement surgery with either fluoroscopic or robotic guidance. Methods: One hundred THAs were included in both the fluoroscopically guided and robotically guided groups in the study. The program TraumaCad was used to analyze the preoperative and 6-week postoperative standing anteroposterior pelvic radiographs used in this study to evaluate the accuracy of component positioning. Results: Robotic-guided surgery demonstrated a small improvement in acetabular inclination error, 3.8 degrees average robotic error vs 4.63 degrees average fluoroscopic error (P < .01). There was no statistically significant difference in accuracy for acetabular anteversion, leg length discrepancy, femoral offset, or global offset difference between the 2 groups. There was also no significant difference in the placement of acetabular components into the Lewinnek safe zone or Callanan safe zone. Both fluoroscopically guided and robotically guided THA patients had similar patterns of error, with excessive anteversion and inclination being more common than inadequate anteversion or inclination. Conclusion: The findings from our study question the use of haptic robotic guidance during direct anterior approach THA when compared to fluoroscopic guidance. (C) 2022 Elsevier Inc. All rights reserved.

Automated summary

This study compared the accuracy of acetabular component placement, leg length discrepancy, femoral offset, and global offset difference between patients who underwent hip replacement surgery with either fluoroscopic or robotic guidance. The results showed that there was a small improvement in acetabular inclination error with robotic-guided surgery, but no significant differences in other measures between the two groups. The findings question the use of robotic guidance in direct anterior approach THA compared to fluoroscopic guidance.