Computer-guided THA may reduce the rate of revision
Computer-guided total hip arthroplasty may be associated with a lower rate of revision, according to published results.
Using the National Joint Registry of England, Wales, Northern Ireland and the Isle of Man, Edward T. Davis, FRCS(Tr&Orth), and colleagues analyzed the results of 42,554 patients who underwent THA for osteoarthritis with cementless acetabular components (Smith & Nephew) between April 2003 and February 2020. Researchers performed an additional analysis limiting the sample size to cementless-only THAs. Researchers considered revision of any component for any reason to be the primary endpoint. They used Kaplan-Meier survivorship analysis and an adjusted Cox proportional-hazards model.
In the analysis of the cementless and hybrid group, researchers found 41,683 cases did not have computer guidance and 871 cases had computer guidance. The group without computer guidance had 943 revisions compared with seven revisions in the computer-guided group, leading to cumulative revision rates at 10 years of 3.88% in the group without computer guidance and 1.06% in the computer-guided group. Researchers noted a hazard ratio of 0.45, according to results of the Cox proportional-hazards model.
In the cementless-only group, researchers found cumulative revision rates at 10 years of 3.99% and 1.20% in the group without computer guidance and computer-guided group, respectively, as well as a hazard ratio of 0.47. The two groups had no significant differences in the 6-month Oxford Hip Score, EuroQol-5D and EQ-VAS scores, and patient-reported success rates, according to results. Researchers noted patients in the computer-guided group reported higher patient satisfaction; however, a reduced number of responses limited this finding, according to researchers.
“We need to push forward with considering the use of navigation in implanting hip replacements,” Davis, of the Royal Orthopaedic Hospital NHS Foundation Trust, told Healio Orthopedics. “I think we still need to generate more evidence, but I think what we are seeing at the moment is certainly leading us down that route of computer assistance. Certainly, we have known for years [computer assistance] improves the precision of what we are doing. I think with the increasing evidence we have now, we are seeing that it may have a significant effect on the survivorship and possibly [patient-reported outcome measures] PROMs.”