Navigation-guided elective primary total hip arthroplasty is associated with reduced 90-day readmission and early revision at increased index cost: a national analysis.

Background: Navigation-guided total hip arthroplasty (THA) has been increasingly adopted to improve implant positioning and early outcomes; however, its population-level clinical and economic impact remains uncertain. Methods: Using the Nationwide Readmissions Database (NRD) (2020-2022), elective primary THA performed on hospital day 0 was identified in this study. Navigation-guided cases were compared with conventional THA. A 1:5 propensity score-matched cohort was constructed adjusting for demographics, payer, comorbidities, calendar year, and hospital characteristics. Primary outcomes included index hospitalization complications and 90-day readmission with readmission-associated procedural escalation. Readmission resource utilization and modeled 100-case episode-of-care costs were assessed. Results: Among 366,375 elective THA procedures, navigation use increased from 2.9% (2020) to 4.3% (2022). In the matched cohort ( Conclusions: Navigation-guided elective THA was associated with improved short-term outcomes but higher upfront charges. Because the NRD does not capture surgical approach, implant positioning, implant-specific details, surgeon volume, or longer-term outcomes, these findings should be interpreted as hypothesis-generating associations rather than definitive evidence of a causal technology effect.