For sufferers present process whole hip arthroplasty (THA), the usage of robotic-assisted surgical procedure and surgical navigation methods is just not related to an elevated threat of periprosthetic joint an infection (PJI), suggests a examine in The Journal of Bone & Joint Surgical procedure. The journal is revealed within the Lippincott portfolio by Wolters Kluwer.
Laptop navigation (CN) and robotic help (RA) don’t alter the chance of PJI after whole hip alternative surgical procedure, in response to the brand new analysis by Alberto V. Carli, MD, and colleagues of Hospital for Particular Surgical procedure, New York.
May CN and RA improve dangers throughout hip alternative?
Laptop navigation and robotic help are more and more used throughout THA. These applied sciences have proven useful results, together with extra correct element positioning and a decrease threat of postoperative instability. Nevertheless, “[I]t stays unknown as as to whether use of [CN and RA] results in an enchancment in long-term purposeful outcomes or implant longevity,” in response to the authors.
The usage of CN and RA requires the presence of further gear and personnel within the working room, and has been linked to longer working instances. Collectively, these elements would possibly result in an elevated threat of surgical-site contamination and PJI, a significant reason for implant failure after THA.
Dr. Carli and colleagues analyzed their hospital’s expertise of almost 13,000 sufferers present process major THA between 2018 and 2021. Throughout this time, CN was used throughout THA in 21% of sufferers and RA in 16%. The remaining 63% of sufferers underwent standard THA with out CN or RA.
Equally low charges of PJI, with or with out new applied sciences
Utilizing a method known as propensity-score matching, the researchers recognized teams of sufferers with comparable threat elements present process THA by standard strategies or with the usage of RA (2,003 sufferers in every group) or CN (2,664 sufferers in every group). Ninety-day charges of PJI have been in contrast between teams, with adjustment for different elements.
Each applied sciences have been related to small will increase in operative instances, in comparison with standard THA: two minutes longer with CN and 11 minutes longer with RA. Earlier research have raised considerations that longer surgical instances would possibly result in elevated threat of problems.
Nevertheless, within the new examine, the incidence of PJI was comparable amongst teams: 0.4% for each CN and RA in contrast with charges of 0.2% and 0.4% for the respective propensity-matched standard THA cohorts. In adjusted analyses, there have been no important variations in PJI threat.
“Though pc navigation and robotic help are at present utilized in a minority of THA procedures, the rise in the usage of such expertise seems to be inevitable within the coming many years,” the researchers write. Their examine provides new proof that, in matched teams of sufferers with comparable traits, the dangers of PJI are comparable, with or with out the usage of CN or RA.
The authors level out some limitations of the examine – notably together with the general low charge of PJI at their specialised, high-volume orthopedic surgical procedure middle. Dr. Carli and coauthors conclude: “Whereas the long-term scientific, purposeful, and implant-longevity outcomes related to the usage of pc navigation or robotic help stay to be elucidated, the findings of the current examine are reassuring with respect to the chance of an infection.”
LaValva, S. M., et al. (2024). Robotics and Navigation Do Not Have an effect on the Threat of Periprosthetic Joint An infection Following Main Complete Hip Arthroplasty. The Journal of Bone and Joint Surgical procedure. doi.org/10.2106/jbjs.23.00289.