Clinical efficacy of robot-assisted total hip arthroplasty for developmental dysplasia of the hip: A meta-analysis.

OBJECTIVES

The aim of this meta-analysis was to compare the clinical efficacy of robot-assisted total hip arthroplasty (R-THA) versus conventional total hip arthroplasty (C-THA) for the treatment of developmental dysplasia of the hip (DDH).

MATERIALS AND

METHODS

Eligible articles published until May 2025 were searched from the Cochrane Library, Web of Science, PubMed, Embase, ScienceDirect, and Springer. Search terms included "robot-assisted", "developmental dysplasia of the hip", "total hip arthroplasty", using mean differences (MDs) and risk differences (RDs) as combined variables, and selecting 95% as the confidence interval (CI).

RESULTS

Seven clinical studies with a total of 876 patients were finally included in this study. There were no significant differences between the two groups in terms of cup inclination (MD=0.07; 95% CI: -0.95 ~ 1.10; p=0.89), cup anteversion (MD=-4.02; 95% CI: -9.59 ~ 1.55; p=0.16), intraoperative bleeding (MD=11.25; 95% CI: -56.02 ~ 78.52; p=0.74), operative time (MD=3.03; 95% CI: -15.66 ~ 21.72; p=0.75), postoperative complications (dislocation [RD=-0.01; 95% CI: -0.03 ~ 0.01; p=0.26], deep infection [RD=0.01; 95% CI: -0.01 ~ 0.02; p=0.37] and nerve injury [RD=0.01; 95% CI: -0.01 ~ 0.03; p=0.56], revision/reoperation [RD=-0.00; 95% CI: -0.03 ~ 0.03; p=1.00], and absolute vertical distance of center of rotation [COR] [MD=-0.50; 95% CI: -1.07 ~ 0.06; p=0.08]). However, compared to the C-THA group, the R-THA group showed significantly higher Harris Hip Score (HHS) (MD=2.17, 95% CI: 0.11 ~ 4.22, p=0.04) and more accurate placement of the horizontal COR (MD=-0.77; 95% CI: -1.21 ~ -0.32; p=0.0008).

CONCLUSION

In the R-THA group, the accuracy of horizontal placement of the COR was moderately improved, and the postoperative HHS was higher than that in the C-THA group, although such differences might not be obviously perceived by patients. Additionally, no significant differences were found between the two groups in other surgery-related parameters and safety.