Short-term Pain Outcomes in Robotic versus Manual Total Hip Arthroplasty

Background: Four-hundred-fifty-thousand patients annually undergo total hip arthroplasty (THA) in the United States. THA has been shown to alleviate pain, restore function, and improve quality of life. Manual implant postoperative complications have led to a need for more advanced technology. Robotic assisted THA has the potential for greater accuracy in component positioning compared to manual. Comparing robotic and manual THA, significant differences have been shown in hip-specific functional outcomes, component positioning, complications, and patient-centered outcomes. The effects of these techniques on differences from baseline pain have yet to be investigated. Methods: A retrospective review of the Berkshire Medical Center electronic medical record system identified 70 patients undergoing THA between March 1, 2020 to October 31, 2021 with preoperative diagnosis of osteoarthritis or degenerative joint disease of the hip. Patients were admitted for at least one day postoperatively with documented preoperative and POD1 vital signs, POD1 pain scores, and LOS were included. The primary objective was to identify differences in postoperative day 1 (POD1) pain scores between robotic and manual THA. The secondary objective was to identify differences in length of stay (LOS) and preoperative versus postoperative vital signs (blood pressure, heart rate) between groups. Results: A statistically significant difference was identified for postoperative pain scores indicating significantly lower pain scores in patients undergoing manual THA in comparison to robotic (3.0 versus 5.0; P = 0.01). No significant differences were identified for systolic blood pressure (P = 0.46), diastolic blood pressure (P = 0.43), heart rate (p = 0.93), or LOS (P = 0.35). Discussion: Previous studies have demonstrated decreases in postoperative pain, LOS, and costs in patients undergoing robotic versus manual THA. The results of our study were not consistent with these studies which may be due to small sample size, quantity of anesthetic used, and surgeon differences. THA performed via robotic technique demonstrated a statistically significant increase in postoperative pain outcomes when compared to manual. There may be a lack of clinical difference in postoperative pain scores between groups and no differences were identified for vital signs or LOS