Conclusion The results of this meta- analysis suggest that robotic-assisted THA has certain advantages over conventional THA , including the results of component positioning and rates of intraoperative complications .
Background Robotic-assisted total hip arthroplasty ( THA ) allows for accurate preoperative planning and component positioning , potentially enhancing implant survival and long-term outcomes .
The relative efficacy and safety of robotic-assisted and conventional THA , however , are unclear .
This systematic review and meta- analysis compared the safety and efficacy of robotic-assisted and conventional THA .
Comparison of robotic-assisted and manual implantation of a primary total hip replacement. A prospective study.
BACKGROUND Robotic-assisted total hip replacement  has become a common method of implantation , especially in Europe . It frequently has been postulated that robotic reaming would result in an improved clinical outcome due to the better fit of the prosthesis , but that has never been demonstrated in a prospect i ve study , to our knowledge . The purpose of this study was to compare robotic-assisted implantation of a total hip replacement with conventional manual implantation . METHODS One hundred and fifty-four patients scheduled for total hip replacement were r and omly assigned to undergo either conventional manual implantation of an S-ROM prosthesis ( eighty patients ) or robotic-assisted implantation of such a prosthesis ( seventy-four patients ) . The five-axis ROBODOC was used for the robotic-assisted procedures . Preoperatively as well as at three , six , twelve , and twenty-four months after surgery , the scores according to the Harris and Merle d'Aubigné systems and the Mayo clinical score were determined . Radiographs made at these intervals were analyzed for evidence of loosening , prosthetic alignment , and heterotopic ossification . RESULTS Thirteen ( 18 % ) of the seventy-four attempted robotic implantations had to be converted to manual implantations as a result of failure of the system . The duration of the robotic procedures  was longer than that of the manual procedures ( mean and st and ard deviation,107.1 + /- 29.1 compared with 82.4 + /- 23.4 minutes , p < 0.001 ) . Limb-length e quality ( mean discrepancy , 0.18 + /- 0.30 compared with 0.96 + /- 0.93 cm , p < 0.001 ) and varus-valgus orientation of the stem ( mean angle between the femur and the shaft of the prosthesis , 0.34 degrees + /- 0.67 degrees compared with 0.84 degrees + /- 1.23 degrees , p < 0.001 ) were better after the robotic procedures . At six months , slightly more heterotopic ossification was seen in the group treated with robotic implantation . The group treated with robotic implantation had a better Mayo clinical score at six and twelve months and a better Harris score at twelve months ; however , by twenty-four months , no difference was found between the groups with regard to any of the three scores . Dislocation was more frequent in the group treated with robotic implantation : it occurred in eleven of the sixty-one patients in that group compared with three of eighty in the other group ( p < 0.001 ) . Recurrent dislocation and pronounced limping were indications for revision surgery in eight of the sixty-one patients treated with robotic implantation compared with none of the seventy-eight ( excluding two with revision for infection ) treated with manual insertion ( p < 0.001 ) . Rupture of the gluteus medius tendon was observed during all of the revision operations . CONCLUSIONS The robotic-assisted technology had advantages in terms of preoperative planning and the accuracy of the intraoperative procedure . Disadvantages were the high revision rate ; the amount of muscle damage , which we believe was responsible for the higher dislocation rate ; and the longer duration of surgery . This technology must be further developed before its widespread usage can be justified
Conclusion The results of this meta- analysis suggest that robotic-assisted THA has certain advantages over conventional THA , including the results of component positioning and rates of intraoperative complications .
Background Robotic-assisted total hip arthroplasty ( THA ) allows for accurate preoperative planning and component positioning , potentially enhancing implant survival and long-term outcomes .
The relative efficacy and safety of robotic-assisted and conventional THA , however , are unclear .
This systematic review and meta- analysis compared the safety and efficacy of robotic-assisted and conventional THA .