ArticleLangenbeck's archives of surgery2026
Robotic-assisted total hip arthroplasty in the United States: a nationwide propensity-matched analysis of adoption, outcomes, and complications.
Article in Langenbeck's archives of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- 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.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Article
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3 authors.
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Abstract
purposeRobotic assisted total hip arthroplasty (RA-THA) has been introduced to improve the precision of implant positioning and potentially enhance outcomes in THA. However, large scale national data on its real-world impact are lacking. This study presents the first nationwide analysis of RA-THA using the National Inpatient Sample (NIS), evaluating trends in adoption and comparing perioperative outcomes between RA-THA and conventional THA.
methodsWe performed a retrospective cohort study using the NIS (2016–2022). Adult patients undergoing primary elective THA were identified, and those with robotic assistance were classified using ICD-10 procedural codes for robot-assisted surgery. Propensity score matching (1:1) was employed to create comparable cohorts of RA-THA vs. conventional THA, controlling for patient demographics, hospital characteristics, and comorbidities. Temporal trends in RA-THA utilization were assessed. Outcomes included length of stay (LOS), hospital charges, and in-hospital complications. Matched outcomes were compared with appropriate statistical tests, and relative risks (RR) of specific complications were analyzed.
resultsA total 1.9 million THA cases were identified nationwide, of which 2.9% involved robotic assistance. RA-THA utilization increased significantly over the study period (from 1.2% in 2016 to 6.7% in 2022, P < 0.01). In unmatched comparisons, patients undergoing RA-THA were slightly younger on average and more frequently treated at urban teaching hospitals than those with conventional THA. After propensity matching RA-THA was associated with a shorter mean LOS (by 0.7 days) and higher mean hospital charges (by 10,000$~, P < 0.01). The matched RA-THA cohort had a significantly lower overall complication rate compared to matched conventional. In particular, non-robotic THA patients had higher risks of transfusion, in-hospital prosthetic complications, and venous thromboembolism. A forest plot of matched outcomes demonstrated that conventional THA carried elevated RRs for multiple postoperative complications relative to RA-THA (RR > 1 favoring RA-THA for most complication endpoints).
conclusionsIn this first nationwide analysis of RA-THA, we found that robotic assistance, while still used in a minority of THA cases, grew steadily in adoption through 2022. RA-THA was associated with shorter hospital stays and a reduced risk of in-hospital complications compared to conventional THA, with higher hospitalization costs. These findings suggest that RA-THA can confer perioperative benefits in routine practice, though its economic impact and long-term clinical advantages remain areas for further investigation. Levels of Evidence: LEVEL III.
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