Abstract
Introduction
The use of technology, such as navigation and robotic systems, may improve the accuracy of component positioning in total hip arthroplasty (THA) but its impact on patient reported outcomes measures (PROMs) remains unclear. This study aims to identify the association between intraoperative use of technology and patient reported outcomes measures (PROMs) in patients who underwent primary total hip arthroplasty (THA).
Methods
We retrospectively reviewed patients who underwent primary THA between 2016 and 2020 and answered a post-operative PROM questionnaire. Patients were separated into three groups depending on the technology utilized intraoperatively: navigation, robotics, or no technology (i.e. manual THA. The Forgotten Joint Score (FJS-12) and Hip Disability and Osteoarthritis Outcome Score, Joint Replacement (HOOS, JR) were collected at various time points (FJS: 3m, 1y, and 2y; HOOS, JR: pre-operatively, 3m, and 1y). Demographic differences were assessed with chi-square and ANOVA. Mean scores between all groups were compared using univariate ANCOVA, controlling for observed demographic differences.
Results
Of the 1,960 cases included, 896 navigation, 135 robotics, and 929 manual. There was a significant statistical difference in one-year HOOS, JR scores (85.23 vs. 85.95 vs. 86.76; p=0.014) and two-year FJS-12 scores (64.72 vs. 73.35 vs. 74.63; p=0.004) between the three groups. However, they did not exceed the mean clinically important difference (MCID) at any time period. Short and long-term PROMs significantly differed between navigation and manually performed cases (FJS 3m: p=0.047; FJS 2y: p=0.001; HOOS, JR 1y: p=0.004). Two-year FJS-12 scores statistically differed between navigation and robotics (p=0.038). There was no statistical difference in either FJS-12 or HOOS, JR scores between robotics and manual THA groups at all time points (FJS 3m:p=0.076, 1y:p=0.225, 2y:p=0.793; HOOS, JR preop:p=0.872, 3m:p=0.644, 1y:p=0.531).
Conclusion
Statistical differences observed between all modalities are not likely to be clinically meaningful with regards to early patient reported outcomes. While intraoperative use of technology may improve the accuracy of implant placement, these modalities have not necessarily translated into improved early reported functional outcomes.
