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

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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. 系统综述和荟萃分析优先报告的条目: PRISMA声明. 中西医结合学报, 2009, 7(9): 889-896.
8.	曾宪涛, 刘慧, 陈曦, 等. Meta分析系列之四: 观察性研究的质量评价工具. 中国循证心血管医学杂志, 2012, 4(4): 297-299.
9.	李俊成, 倪明, 冀全博, 等. 机器人辅助与传统方法行全髋关节置换术后下肢长度差异比较. 中华骨科杂志, 2021, 41(8): 480-487.
10.	崔可赜, 郭祥, 陈元良, 等. 后外侧入路人工全髋关节置换术中MAKO机器人手臂辅助与传统人工方法的比较研究. 中国修复重建外科杂志, 2020, 34(7): 883-888.
11.	郭人文, 柴伟, 李想, 等. 机器人辅助在股骨头坏死全髋关节置换术中的应用. 中华骨科杂志, 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. 系统综述和荟萃分析优先报告的条目: PRISMA声明. 中西医结合学报, 2009, 7(9): 889-896.
8. 曾宪涛, 刘慧, 陈曦, 等. Meta分析系列之四: 观察性研究的质量评价工具. 中国循证心血管医学杂志, 2012, 4(4): 297-299.
9. 李俊成, 倪明, 冀全博, 等. 机器人辅助与传统方法行全髋关节置换术后下肢长度差异比较. 中华骨科杂志, 2021, 41(8): 480-487.
10. 崔可赜, 郭祥, 陈元良, 等. 后外侧入路人工全髋关节置换术中MAKO机器人手臂辅助与传统人工方法的比较研究. 中国修复重建外科杂志, 2020, 34(7): 883-888.
11. 郭人文, 柴伟, 李想, 等. 机器人辅助在股骨头坏死全髋关节置换术中的应用. 中华骨科杂志, 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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