Comparison of conventional versus robotic-assisted total hip arthroplasty using the Mako system: An Italian retrospective study

Abstract

Introduction: Our research aimed to evaluate differences in terms of length of hospital stay and clinical outcomes between robotic-arm assisted using MAKO system and standard manual implantation in a group of patients who underwent primary total hip arthroplasty (THA). Methods: Our retrospective, cohort study was conducted between August 2014 and March 2016. From our target population of 376 patients from three hospitals of Tuscany Region, Italy, we randomly selected a sample of 220 patients, who was subdivided in two groups (MAKO system n = 100; Standard technique n = 120). Our evaluation was carried out before and after surgery at 24 months follow-up. Western Ontario and McMaster (WOMAC) Osteoarthritis Index, Harris Hip Modified Score (HHS), and Numeric Pain Rating Score (NPRS) scales were administered. One sample and independent sample T Student tests were used to assess eventual differences within and between groups for the continuous variables. The significance threshold was set up at P < 0.05. Results: Rate of respondents was 48.6% (MAKO system n = 56, 56%; Standard technique n = 51, 42.5%). There was a significant difference in the length of hospital stay, expressed as number of days hospitalized, between the MAKO group (M = 5.14, SD = 1.98) and the standard group (M = 8.11, SD = 1.64) (t(105) = 15.30, P < 0.001). There were no significant differences in preoperative and post-operative scores between robotic-assisted and standard groups in all of the patient-reported outcome measures (PROMs), but we reported a statistically and clinically significant improvement in all of the post-operative PROMs scores for both surgical procedures (P < 0.001). Discussion and Conclusion: Our findings showed that the MAKO™ robotic is a valuable technology that may innovate THA. However, further long-term studies are needed to justify additional costs.

Keywords

• Arhroplasty Hip Replacement
• clinical outcomes
• MAKO system
• Patient Outcome Measures (PROMS) questionnaires