Advertisement

Computerized navigation for total hip arthroplasty is associated with lower complications and ninety-day readmissions: a nationwide linked analysis

  • Elizabeth B. GausdenEmail author
  • Joseph E. Popper
  • Peter K. Sculco
  • Barret Rush
Original Paper

Abstract

Introduction

The objective was to evaluate if the use of CA-THA was associated with lower complications in the first 90 days following THA compared with conventional THA.

Methods

The Nationwide Readmission Database (NRD) was queried to identify patients who underwent THA between 2012 and 2014. The primary outcome was arthroplasty-related complications within the first 90 days following THA. Multivariate models predicting the risk of complications, readmission, and revision-related readmission within 90 days of discharge were created.

Results

A total of 309,252 patients with a minimum 90-day follow-up following elective primary THA were identified. After controlling for age, sex, comorbidities, indication, income, and type of insurance, the use of CA during THA resulted in a 12% reduced odds of 90-day complications (OR 0.88, 95% CI 0.77–0.99, p = 0.04).

Discussion

The use of CA-THA resulted in lower 90-day complication rates and readmission rates compared with traditional THA after controlling for confounding variables. There was no significant difference in the rates of revision surgery between the groups within the first 90 days.

Keywords

Computer-assisted total hip arthroplasty Complications following total hip arthroplasty THA 

Notes

Compliance with ethical standards

Conflict of interest

Dr. Elizabeth B. Gausden has no disclosures.

Dr. Joseph Popper has no disclosures.

Dr. Peter Sculco is a paid consultant for and receives research support from Intellijoint Surgical. Dr. Sculco is also a paid consultant for EOS imaging. This study did not use funds derived from Intellijoint Surgical.

Dr. Barret Rush has no disclosures.

Ethical approval

This article does not contain any studies with animals performed by any of the authors. As a large database study, informed consent was waived for this study.

Supplementary material

264_2019_4475_MOESM1_ESM.docx (15 kb)
ESM 1 (DOCX 15 kb)

References

  1. 1.
    Kurtz SM, Lau EC, Ong KL et al (2017) Which clinical and patient factors influence the national economic burden of hospital readmissions after total joint arthroplasty? Clin Orthop Relat Res 475:2926–2937.  https://doi.org/10.1007/s11999-017-5244-6 CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Dorr LD, Malik A, Wan Z, et al (2007) Precision and bias of imageless computer navigation and surgeon estimates for acetabular component position. In: Clinical Orthopaedics and Related Research. Lippincott Williams and Wilkins, pp 92–99Google Scholar
  3. 3.
    Ellapparadja P, Mahajan V, Deakin AH, Deep K (2015) Reproduction of hip offset and leg length in navigated total hip arthroplasty: how accurate are we? J Arthroplast 30:1002–1007.  https://doi.org/10.1016/j.arth.2015.01.027 CrossRefGoogle Scholar
  4. 4.
    Ryan C, Price V, John P et al (2010) Kasabach-Merritt phenomenon: a single centre experience. Eur J Haematol 84:97–104CrossRefGoogle Scholar
  5. 5.
    Verdier N, Billaud A, Masquefa T et al (2016) EOS-based cup navigation: randomised controlled trial in 78 total hip arthroplasties. Orthop Traumatol Surg Res 102:417–421.  https://doi.org/10.1016/j.otsr.2016.02.006 CrossRefPubMedGoogle Scholar
  6. 6.
    Shah SM, Deep K, Siramanakul C et al (2017) Computer navigation helps reduce the incidence of noise after ceramic-on-ceramic total hip arthroplasty. J Arthroplast 32:2783–2787.  https://doi.org/10.1016/j.arth.2017.04.019 CrossRefGoogle Scholar
  7. 7.
    Parratte S, Ollivier M, Lunebourg A et al (2016) No benefit after THA performed with computer-assisted cup placement: 10-year results of a randomized controlled study. Clin Orthop Relat Res 474:2085–2093.  https://doi.org/10.1007/s11999-016-4863-7 CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Abdel MP, von Roth P, Jennings MT et al (2016) What safe zone? The vast majority of dislocated THAs are within the Lewinnek safe zone for acetabular component position. Clin Orthop Relat Res 474:386–391.  https://doi.org/10.1007/s11999-015-4432-5 CrossRefPubMedGoogle Scholar
  9. 9.
    Esposito CI, Gladnick BP, Lee Y-Y et al (2015) Cup position alone does not predict risk of dislocation after hip arthroplasty. J Arthroplast 30:109–113.  https://doi.org/10.1016/j.arth.2014.07.009 CrossRefGoogle Scholar
  10. 10.
    Dyrhovden GS, Fenstad AM, Furnes O, Gøthesen Ø (2016) Survivorship and relative risk of revision in computer-navigated versus conventional total knee replacement at 8-year follow-up. Acta Orthop 87:592–599.  https://doi.org/10.1080/17453674.2016.1244884 CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Kim YH, Park JW, Kim JS (2012) Computer-navigated versus conventional total knee arthroplasty: a prospective randomized trial. J Bone Jt Surg - Ser A 94:2017–2024.  https://doi.org/10.2106/JBJS.L.00142 CrossRefGoogle Scholar
  12. 12.
    De Steiger RN, Liu YL, Graves SE (2015) Computer navigation for total knee arthroplasty reduces revision rate for patients less than sixty-five years of age. J Bone Jt Surg - Am Vol 97:635–642.  https://doi.org/10.2106/JBJS.M.01496 CrossRefGoogle Scholar
  13. 13.
    Gausden EB, Parhar HS, Popper JE et al (2018) Risk factors for early dislocation following primary elective Total hip Arthroplasty. J Arthroplast 33.  https://doi.org/10.1016/j.arth.2017.12.034 CrossRefGoogle Scholar
  14. 14.
    New Haven Health Services Corporation Y, for Outcomes Research C, Ynhhsc E (2014) 2014 Procedure-specific readmission measures updates and specifications report elective primary total hip arthroplasty (tha) and/or total knee arthroplasty (TKA)-Version 3.0Google Scholar
  15. 15.
    D’Apuzzo M, Westrich G, Hidaka C et al (2017) All-cause versus complication-specific readmission following total knee arthroplasty. J Bone Joint Surg Am 99:1093–1103.  https://doi.org/10.2106/JBJS.16.00874 CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Sibia US, Mandelblatt AE, Callanan MA et al (2017) Incidence, risk factors, and costs for hospital returns after total joint arthroplasties. J Arthroplast 32:381–385.  https://doi.org/10.1016/j.arth.2016.08.003 CrossRefGoogle Scholar
  17. 17.
    Montgomery BK, Bala A, Huddleston JI et al (2019) Computer navigation vs conventional total hip arthroplasty: a Medicare database analysis. J Arthroplasty 34:1994–1998.e1.  https://doi.org/10.1016/j.arth.2019.04.063 CrossRefPubMedGoogle Scholar
  18. 18.
    Bohl DD, Nolte MT, Ong K et al (2019) Computer-assisted navigation is associated with reductions in the rates of dislocation and acetabular component revision following primary total hip arthroplasty. J Bone Jt Surg - Am Vol 101:250–256.  https://doi.org/10.2106/JBJS.18.00108 CrossRefGoogle Scholar
  19. 19.
    Aoude AA, Aldebeyan SA, Nooh A et al (2016) Thirty-day complications of conventional and computer-assisted total knee and total hip arthroplasty: analysis of 103,855 patients in the American College of Surgeons National Surgical Quality Improvement Program Database. J Arthroplast 31:1674–1679.  https://doi.org/10.1016/j.arth.2016.01.042 CrossRefGoogle Scholar
  20. 20.
    Najarian BC, Kilgore JE, Markel DC (2009) Evaluation of component positioning in primary total hip arthroplasty using an imageless navigation device compared with traditional methods. J Arthroplast 24:15–21.  https://doi.org/10.1016/j.arth.2008.01.004 CrossRefGoogle Scholar
  21. 21.
    Beringer DC, Patel JJ, Bozic KJ (2007) An overview of economic issues in computer-assisted total joint arthroplasty. Clin Orthop Relat Res 463:26–30PubMedGoogle Scholar

Copyright information

© SICOT aisbl 2020

Authors and Affiliations

  1. 1.Department of OrthopedicsHospital for Special SurgeryNew YorkUSA
  2. 2.Mohawk Valley OrthopedicsAmsterdamUSA
  3. 3.Division of Critical Care MedicineUniversity of ManitobaWinnipegCanada

Personalised recommendations