Robotic assisted hip and knee replacements shows no clear benefit over conventional methods
· News-MedicalSo researchers analyzed data from the National Joint Registry for 666,283 total hip replacements (656,080 conventional and 10,203 robotic) and 697,145 total or partial knee replacements (675,034 conventional and 22,111 robotic) performed between 2018 and 2024 in public and private hospitals across the UK.
They used a statistical technique called propensity score matching to balance out underlying differences between patients having conventional or robotic surgery, allowing them to draw more reliable conclusions. Other potentially influential factors, such as age, sex, body mass index, diagnosis, physical fitness, implant type and surgeon volume were also taken into account.
They then compared a range of outcomes including implant survival, patient survival, reasons for revision and complications during surgery for an average of 2.5 years after surgery.
The results show no differences in implant survival, or overall or cause-specific revision risk and complications during surgery between conventional and robotic hip and knee replacement groups. Nor was there any difference in patient survival between conventional and robotic hip replacement groups.
Robotic surgery was, however, associated with a lower risk of hip revisions that may be related to implant malpositioning than conventional surgery.
These are observational studies, so no firm conclusions can be drawn about cause and effect. The authors also acknowledge that other unmeasured factors could have affected their findings and note that the limited follow-up period may mask longer term outcomes.
However, they point out that target trial emulation is one of the most robust methods for analysing observational data, providing vital insights to help commissioners plan care.
As such, they conclude: "These results highlight the importance of careful evaluation of robotic technology in publicly funded healthcare systems, given the substantially higher capital and procedural costs involved."
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