Robotic arm-assisted total hip arthroplasty for preoperative planning and intraoperative decision-making

Aims This article aimed to explore the efficacy of robotic arm-assisted total hip arthroplasty (THA) in improving preoperative planning and intraoperative decision-making. Methods In this single-center, prospective, randomized clinical controlled trial, 60 patients were randomly divided into two groups: conventional THA (cTHA) and robotic arm-assisted THA (rTHA). The rTHA underwent procedures using a robot-assisted surgical system, which generated three-dimensional models to determine the most appropriate prosthesis size and position. The standard process of replacement was executed in cTHA planned preoperatively via X-ray by experienced surgeons. Differences between predicted and actual prosthetic size, prosthetic position, and leg length were evaluated. Results Sixty patients were included in the study, but one patient was not allocated due to anemia. No significant preoperative baseline data difference was found between the two groups. The actual versus predicted implantation size of both groups revealed that 27/30 (90.0%) in the rTHA group and 25/29 (86.2%) in the cTHA group experienced complete coincidence. The coincidence rate for the femoral stem was higher in the rTHA group (83.3%) than that in the cTHA group (62.7%). Between the actual and predicted rTHA, the difference in anteversion/inclination degree (< 6[degrees]) was largely dispersed, while cTHA was more evenly distributed in degree (< 9[degrees]). The differences in leg length between the surgical side and contralateral side showed a significant deviation when comparing the two groups (P = 0.003), with 0.281 (- 4.17 to 3.32) mm in rTHA and 3.79 (1.45-6.42) mm in cTHA. Conclusion Robotic arm-assisted total hip arthroplasty can be valuable for preoperative planning and intraoperative decision-making. Keywords: Total hip arthroplasty, Robot-assisted surgery, Preoperative planning, Intraoperative decision-making