Is robot-assisted total hip arthroplasty associated with fewer overall revisions and better patient-reported outcome measures than conventional THA? - PROMs
Approval date: July 11th 2025
Starting date: August 14th 2025
LW van Hemert, PJ Marang-van de Mheen, EJW Geilen, G Ayerdem, ES Veltman, WP Zijlstra, NMC Mathijsen, J Most, EH van Haaren
Research proposal abstract
Where previous studies have shown that robot-assisted total hip arthroplasty (THA) improves implant accuracy or provides more patient-specific perioperative implant planning and alignment, the impact on clinical outcomes such as (early) revision risks is still debated. In addition, relatively few studies have investigated the impact of robot-assisted total hip arthroplasty (raTHA) on patient-reported outcome measures (PROMs).
The aim of the present study therefore is to assess the extent to which robot-assisted rather than conventional primary total hip arthroplasty is associated with 1) fewer overall cumulative revision rates and 2) improved patient-reported outcome measures, while taking into account any differences in patient characteristics, surgical factors and neighborhood socio-economic status.
From the Dutch Arthroplasty Register (LROI), all registered primary raTHA and conventional primary THA operated between January 01, 2022, and December 31, 2024, in patients >18 years of age will be included.
Two sub-studies will be conducted, focusing on overall cumulative revision rates as primary endpoint (sub-study 1) and patient-reported outcome measures as primary endpoint (sub-study 2). In addition, patient-specific factors, surgical factors and neighborhood socio-economic status (SES) are collected for every patient in every procedure performed.
In sub-study 1, Cox Proportional-Hazards analysis will be used to assess the impact on overall revision rates, with predisposing patient-specific and surgical factors, neighborhood SES as well as raTHA versus conventional THA as independent variables.
In sub-study 2, linear regression analysis will be used to assess the impact of raTHA on PROMs and patient satisfaction, adjusting for differences in preoperative PROMs and patient characteristics. We will explore the impact of differences in implants used and surgical approach.