ArticleJournal of robotic surgery2026
Robot-assisted elimination of side disparity in acetabular cup placement by right-handed surgeons during total hip arthroplasty: a comparative study of manual and robotic techniques.
Article in Journal of robotic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Total hip arthroplasty (THA) requires precise acetabular cup placement to ensure long-term success. Despite the widely accepted “safe zone,” manual THA outcomes can be influenced by surgeon handedness, leading to side-dependent disparities in cup positioning, especially among right-handed surgeons. This study aimed to compare the consistency of acetabular cup placement between left and right sides in robotic-assisted (RA-THA) versus manual THA (M-THA) performed by right-handed surgeons. A retrospective cohort of 220 patients who underwent primary unilateral THA via posterolateral approach was included. Patients were divided into RA-THA (n = 110) and M-THA (n = 110) groups, each further stratified by operative side (left/right). Radiographic parameters (inclination, anteversion, limb length discrepancy, femoral/acetabular offset), safe zone achievement, perioperative outcomes, and early clinical results were assessed. Results showed that in the M-THA group, left-side procedures exhibited significantly greater anteversion (25.5°±6.2° vs. 22.9°±3.8°, p = 0.009), larger limb length discrepancy (0.7 ± 0.3 mm vs. 0.5 ± 0.2 mm, p < 0.001), and greater offset deviations compared to right-side procedures. In contrast, the RA-THA group demonstrated no significant side-to-side differences in any radiographic parameters, with consistently higher safe zone placement rates (92.7–94.5%). Operative time was longer for left-side M-THA compared to right-side (p = 0.041), while RA-THA showed no such disparity. Early clinical outcomes and complication rates were comparable between groups. Robotic-assisted THA effectively eliminates side-dependent disparities in acetabular cup placement attributable to surgeon handedness, ensuring high precision and consistency regardless of operative side. While short-term functional outcomes are similar, robotic assistance provides a standardized technical foundation for long-term implant survivorship and may serve as an equalizing tool in surgical training and procedural standardization.
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