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Computer Guided THA May Help Reduce Revision Rates

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A recent study has shown encouraging evidence that performing total hip arthroplasty using computer-guided methods may reduce the risk of needing a revision. The study, published just this year (2021), analyzed 41,683 non-computer-guided cases and 871 computer-guided cases by using the patient-reported outcome measures (PROMs) data of the National Joint Registry of England, Wales, Northern Ireland and the Isle of Man. The sample used cementless acetabular components from a single manufacturer (Smith & Nephew) and included a combination of cementless and hybrid THAs as well as a smaller sample of cementless only THAs. The cases analyzed spanned from April 2003 to February 2020. 

The results for the cementless and hybrid THA group ended with a total of 943 revisions in the non-computer-guided group and 7 revisions in the computer-guided group. The data revealed a significantly lower cumulative revision rate at 10 years in the computer-guided group of just 1.06% compared to 3.88% in the non-computer-guided group. In the cementless-only sample of THAs the cumulative revision rate at 10 years was 1.20% for the computer-guided group and 3.99% for the non-guided group. 

Interestingly enough, the study found no real significant difference between the two groups when it came to the various patient-reported outcome measures. There was one exception to this being the single-item patient satisfaction question which significantly favored the computer-guided group, however, was limited due to reduced number of responses. The study also could not determine which types of computer-guided systems were used.

Despite a couple of limitations with the study, the findings are highly encouraging for computer-guided systems being the way of the future not only in total hip arthroplasty cases but in all joint arthroplasty cases. We know that computer-guided systems have shown a dramatic increase in implant sizing and placement accuracy, but to now have evidence that revisions can be reduced is good news for everyone. 

Original Article Below:

https://journals.lww.com/jbjsoa/pages/articleviewer.aspx?year=2021&issue=09000&article=00011&type=Fulltext&context=LatestArticles

Davis, Edward T. FRCS(Tr&Orth)1,2; McKinney, Kerren D. MSc3; Kamali, Amir PhD3; Kuljaca, Selena PhD3; Pagkalos, Joseph FRCS(Tr&Orth)1,a Reduced Risk of Revision with Computer-Guided Versus Non-Computer-Guided THA, JBJS Open Access: July-September 2021 – Volume 6 – Issue 3 – e21.00006

doi: 10.2106/JBJS.OA.21.00006

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