Meta-analysis of leg length discrepancy after robot-assisted and traditional total hip arthroplasty_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

TU Yuanyuan , WAN Dadi ,  WANG Qunli

Orthopaedic Medical Center, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine, Haikou Hainan, 570208, P. R. China;

Corresponding?author：

WANG Qunli, Email: qunli_wang@163.com

Keywords：

Robot assist system; total hip arthroplasty; Meta-analysis; systematic review; cohort study

DOI：

10.7507/1002-1892.202112111

Video：

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Objective To systematically evaluate the difference in leg length discrepancy (LLD) between robot-assisted total hip arthroplasty (THA) and traditional THA. Methods The Cochrane Library, PubMed, Web of Science, EMbase, CNKI, Wanfang, VIP, and CBM databases were searched by computer to collect cohort studies of robot-assisted and traditional THAs from inception to August 11th, 2021. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias of the included studies. Meta-analysis was performed using RevMan 5.3 software. Results A total of 10 high-quality cohort studies were included. The results of Meta-analysis showed that compared with traditional THA, LLD after robot-assisted THA was smaller [MD=?1.64, 95%CI (?2.25, ?1.04), P<0.001], Harris scores at 3 and 12 months after operation were higher [MD=1.50, 95%CI (0.44, 2.57), P=0.006; MD=7.60, 95%CI (2.51, 12.68), P=0.003]. However, the operative time was longer [MD=8.36, 95%CI (4.56, 12.17), P<0.000 1], and the postoperative acetabular anteversion angle was larger [MD=1.91, 95%CI (1.43, 2.40), P<0.001]. There was no significant difference in Harris score at 6 months, amnesia index (Forgotten joint score, FJS), postoperative acetabular abduction angle, and incidence of complication between the two groups (P>0.05). Conclusion Robot-assisted THA is superior to traditional THA in postoperative LLD.

Citation： TU Yuanyuan, WAN Dadi, WANG Qunli. Meta-analysis of leg length discrepancy after robot-assisted and traditional total hip arthroplasty. Chinese Journal of Reparative and Reconstructive Surgery, 2022, 36(5): 561-566. doi: 10.7507/1002-1892.202112111 Copy

1.	Learmonth ID, Young C, Rorabeck C. The operation of the century: total hip replacement. Lancet, 2007, 370(9597): 1508-1519.
2.	Ng VY, Kean JR, Glassman AH. Limb-length discrepancy after hip arthroplasty. J Bone Joint Surg (Am), 2013, 95(15): 1426-1436.
3.	Edwards BN, Tullos HS, Noble PC. Contributory factors and etiology of sciatic nerve palsy in total hip arthroplasty. Clin Orthop Relat Res, 1987, (218): 136-141.
4.	Giles LG, Taylor JR. Low-back pain associated with leg length inequality. Spine (Phila Pa 1976), 1981, 6(5): 510-521.
5.	O'Brien S, Kernohan G, Fitzpatrick C, et al. Perception of imposed leg length inequality in normal subjects. Hip Int, 2010, 20(4): 505-511.
6.	Kim SC, Lim YW, Kwon SY, et al. Effect of leg-length discrepancy following total hip arthroplasty on collapse of the contralateral hip in bilateral non-traumatic osteonecrosis of the femoral head. Bone Joint J, 2019, 101-B(3): 303-310.
7.	Moher D, Liberati A, Tetzlaff J, et al. 系統綜述和薈萃分析優先報告的條目: PRISMA聲明. 中西醫結合學報, 2009, 7(9): 889-896.
8.	曾憲濤, 劉慧, 陳曦, 等. Meta分析系列之四: 觀察性研究的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(4): 297-299.
9.	李俊成, 倪明, 冀全博, 等. 機器人輔助與傳統方法行全髖關節置換術后下肢長度差異比較. 中華骨科雜志, 2021, 41(8): 480-487.
10.	崔可賾, 郭祥, 陳元良, 等. 后外側入路人工全髖關節置換術中MAKO機器人手臂輔助與傳統人工方法的比較研究. 中國修復重建外科雜志, 2020, 34(7): 883-888.
11.	郭人文, 柴偉, 李想, 等. 機器人輔助在股骨頭壞死全髖關節置換術中的應用. 中華骨科雜志, 2020, 40(13): 819-827.
12.	Kong X, Yang M, Jerabek S, et al. A retrospective study comparing a single surgeon’s experience on manual versus robot-assisted total hip arthroplasty after the learning curve of the latter procedure—A cohort study. Int J Surg, 2020, 77: 174-180.
13.	Domb BG, Chen JW, Lall AC, et al. Minimum 5-year outcomes of robotic-assisted primary total hip arthroplasty with a nested comparison against manual primary total hip arthroplasty: A propensity score-matched study. J Am Acad Orthop Surg, 2020, 28(20): 847-856.
14.	Kayani B, Konan S, Huq SS, et al. The learning curve of robotic-arm assisted acetabular cup positioning during total hip arthroplasty. Hip Int, 2021, 31(3): 311-319.
15.	Bargar WL, Parise CA, Hankins A, et al. Fourteen year follow-up of randomized clinical trials of active robotic-assisted total hip arthroplasty. J Arthroplasty, 2018, 33(3): 810-814.
16.	Domb BG, El Bitar YF, Sadik AY, et al. Comparison of robotic-assisted and conventional acetabular cup placement in THA: a matched-pair controlled study. Clin Orthop Relat Res, 2014, 472(1): 329-336.
17.	Nakamura N, Sugano N, Nishii T, et al. A comparison between robotic-assisted and manual implantation of cementless total hip arthroplasty. Clin Orthop Relat Res, 2010, 468(4): 1072-1081.
18.	Honl M, Dierk O, Gauck C, et al. Comparison of robotic-assisted and manual implantation of a primary total hip replacement. A prospective study. J Bone Joint Surg (Am), 2003, 85(8): 1470-1478.
19.	Manzotti A, Cerveri P, De Momi E, et al. Does computer-assisted surgery benefit leg length restoration in total hip replacement? Navigation versus conventional freehand. Int Orthop, 2009, 35(1): 19-24.
20.	Redmond JM, Gupta A, Hammarstedt JE, et al. The learning curve associated with robotic-assisted total hip arthroplasty. J Arthroplasty, 2015, 30(1): 50-54.

1. Learmonth ID, Young C, Rorabeck C. The operation of the century: total hip replacement. Lancet, 2007, 370(9597): 1508-1519.
2. Ng VY, Kean JR, Glassman AH. Limb-length discrepancy after hip arthroplasty. J Bone Joint Surg (Am), 2013, 95(15): 1426-1436.
3. Edwards BN, Tullos HS, Noble PC. Contributory factors and etiology of sciatic nerve palsy in total hip arthroplasty. Clin Orthop Relat Res, 1987, (218): 136-141.
4. Giles LG, Taylor JR. Low-back pain associated with leg length inequality. Spine (Phila Pa 1976), 1981, 6(5): 510-521.
5. O'Brien S, Kernohan G, Fitzpatrick C, et al. Perception of imposed leg length inequality in normal subjects. Hip Int, 2010, 20(4): 505-511.
6. Kim SC, Lim YW, Kwon SY, et al. Effect of leg-length discrepancy following total hip arthroplasty on collapse of the contralateral hip in bilateral non-traumatic osteonecrosis of the femoral head. Bone Joint J, 2019, 101-B(3): 303-310.
7. Moher D, Liberati A, Tetzlaff J, et al. 系統綜述和薈萃分析優先報告的條目: PRISMA聲明. 中西醫結合學報, 2009, 7(9): 889-896.
8. 曾憲濤, 劉慧, 陳曦, 等. Meta分析系列之四: 觀察性研究的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(4): 297-299.
9. 李俊成, 倪明, 冀全博, 等. 機器人輔助與傳統方法行全髖關節置換術后下肢長度差異比較. 中華骨科雜志, 2021, 41(8): 480-487.
10. 崔可賾, 郭祥, 陳元良, 等. 后外側入路人工全髖關節置換術中MAKO機器人手臂輔助與傳統人工方法的比較研究. 中國修復重建外科雜志, 2020, 34(7): 883-888.
11. 郭人文, 柴偉, 李想, 等. 機器人輔助在股骨頭壞死全髖關節置換術中的應用. 中華骨科雜志, 2020, 40(13): 819-827.
12. Kong X, Yang M, Jerabek S, et al. A retrospective study comparing a single surgeon’s experience on manual versus robot-assisted total hip arthroplasty after the learning curve of the latter procedure—A cohort study. Int J Surg, 2020, 77: 174-180.
13. Domb BG, Chen JW, Lall AC, et al. Minimum 5-year outcomes of robotic-assisted primary total hip arthroplasty with a nested comparison against manual primary total hip arthroplasty: A propensity score-matched study. J Am Acad Orthop Surg, 2020, 28(20): 847-856.
14. Kayani B, Konan S, Huq SS, et al. The learning curve of robotic-arm assisted acetabular cup positioning during total hip arthroplasty. Hip Int, 2021, 31(3): 311-319.
15. Bargar WL, Parise CA, Hankins A, et al. Fourteen year follow-up of randomized clinical trials of active robotic-assisted total hip arthroplasty. J Arthroplasty, 2018, 33(3): 810-814.
16. Domb BG, El Bitar YF, Sadik AY, et al. Comparison of robotic-assisted and conventional acetabular cup placement in THA: a matched-pair controlled study. Clin Orthop Relat Res, 2014, 472(1): 329-336.
17. Nakamura N, Sugano N, Nishii T, et al. A comparison between robotic-assisted and manual implantation of cementless total hip arthroplasty. Clin Orthop Relat Res, 2010, 468(4): 1072-1081.
18. Honl M, Dierk O, Gauck C, et al. Comparison of robotic-assisted and manual implantation of a primary total hip replacement. A prospective study. J Bone Joint Surg (Am), 2003, 85(8): 1470-1478.
19. Manzotti A, Cerveri P, De Momi E, et al. Does computer-assisted surgery benefit leg length restoration in total hip replacement? Navigation versus conventional freehand. Int Orthop, 2009, 35(1): 19-24.
20. Redmond JM, Gupta A, Hammarstedt JE, et al. The learning curve associated with robotic-assisted total hip arthroplasty. J Arthroplasty, 2015, 30(1): 50-54.

Chinese Journal of Reparative and Reconstructive Surgery

Meta-analysis of leg length discrepancy after robot-assisted and traditional total hip arthroplasty

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