Robotic-assisted primary total hip arthroplasty is not associated with superior clinically meaningful patient-reported outcomes or complication rates in obese patients: a propensity-matched analysis.

PURPOSE: Obesity is increasingly prevalent among total hip arthroplasty (THA) patients and is associated with greater complications and worse patient-reported outcome measures (PROMs). Robotic-assisted THA (R-THA) improves component positioning compared to conventional, manual THA (C-THA); however, its impact on PROMs in obese patients remains unclear. This study aimed to evaluate postoperative PROMs and complications between obese patients undergoing C-THA and R-THA using a propensity-matched analysis.

METHODS

A single-institution database was used to identify 4136 consecutive primary THA patients. Patients with body mass index > 30 and at least two years of follow-up were included. Propensity matching was conducted in a 3:1 ratio, which led to balanced attributes between 267 C-THA and 89 R-THA patients (P > 0.05). The mean absolute and delta scores were compared. Minimal clinically important difference (MCID) thresholds were calculated and patients were categorized as improved, unchanged, or worsened. The medical and surgical complications were recorded.

RESULTS

Absolute and delta scores for all PROMs were similar between groups (P > 0.05). There were no significant differences in MCID-level improvement rates for any PROM (P > 0.05). There were no significant differences in 90-day or one- or two-year complication rates (P > 0.05).

CONCLUSION

In obese patients, C-THA and R-THA did not differ in clinically meaningful improvement across multiple PROMs or complication rates. Within this single-institution cohort, R-THA was not associated with superior patient-centered outcomes compared to C-THA.