High Satisfaction, Modest Differences: A Comparative Cohort Study of Robotic-Assisted and Conventional Total Hip Arthroplasty
5 affiliations
- 1Department of Orthopaedic Surgery, Hospital Recoletas Salud Campo Grande, 47007 Valladolid, Spain
- 2Facultad de Ciencias de la Salud, Universidad Europea Miguel de Cervantes, 47012 Valladolid, Spain
- 3Department of Orthopaedic Surgery, Hospital Universitario de Canarias, 38320 Tenerife, Spain
- 4Facultad de Ciencias de la Salud, Universidad de La Laguna, 38200 San Cristóbal de La Laguna, Spain
- 5Department of Orthopaedic Surgery, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
Abstract
Background/Objectives: Robotic-assisted total hip arthroplasty (raTHA) improves the accuracy and reproducibility of acetabular component positioning compared with conventional THA (cTHA), but whether this translates into superior patient-reported outcomes and satisfaction remains debated. Methods: A retrospective comparative cohort study was performed, including all patients who underwent primary raTHA with the Mako system at our institution (September 2024–May 2025) and an equal-sized control group recruited consecutively from an alphabetically ordered list of 172 eligible cTHAs, starting from a randomly selected letter (August 2022–January 2025), with a minimum follow-up of one year. Treatment allocation was determined by insurance coverage. The postoperative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was the primary outcome; the Visual Analog Scale (VAS), modified Harris Hip Score (mHHS) and Forgotten Joint Score-12 (FJS-12) were secondary outcomes, and an overall satisfaction rating and willingness to undergo the surgery again were also recorded. Results: Ninety-three raTHA and 93 cTHA patients were analyzed. Follow-up was longer in the cTHA group (35.6 vs. 15.5 months; p < 0.001). Postoperative WOMAC (10.5 vs. 14.4; mean difference −3.8 points, 95% CI −7.4 to −0.2) and mHHS (86.9 vs. 84.7; mean difference 2.2 points, 95% CI −0.9 to 5.4) differed in rank-based comparisons, favoring raTHA (Mann–Whitney U test, p = 0.020 and p = 0.030, respectively). Point estimates were below the selected clinical-relevance thresholds, but the confidence intervals did not exclude clinically relevant differences; improvement from baseline did not differ between groups. There were no significant differences in VAS, FJS-12, overall satisfaction (9.32 vs. 9.31) or willingness to undergo surgery again (96.8% vs. 97.8%). Conclusions: Given insurance-based allocation, unequal follow-up and unadjusted analyses, robotic-assisted THA was associated with small differences in postoperative WOMAC and mHHS, whose point estimates were below the selected thresholds, although clinically relevant differences cannot be excluded; there were no differences in improvement, pain, joint awareness or satisfaction, which was very high in both groups. These findings do not establish a causal effect of robotic assistance; prospective randomized studies are needed.
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BibTeX
@article{gonzalezmartin2026high,
title = {{High Satisfaction, Modest Differences: A Comparative Cohort Study of Robotic-Assisted and Conventional Total Hip Arthroplasty}},
author = {David González-Martín and Alejandro Herrera-Rodríguez and José María Lomo-Garrote and Juan José González-Álvarez and Francisco Del Canto-Iglesias and Andrés Saldaña-Díaz and José Luis Pais-Brito},
journal = {Journal of clinical medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15197721},
url = {https://europepmc.org/article/PMC/PMC13666259},
note = {CC BY},
}
RIS
TY - JOUR
TI - High Satisfaction, Modest Differences: A Comparative Cohort Study of Robotic-Assisted and Conventional Total Hip Arthroplasty
AU - David González-Martín
AU - Alejandro Herrera-Rodríguez
AU - José María Lomo-Garrote
AU - Juan José González-Álvarez
AU - Francisco Del Canto-Iglesias
AU - Andrés Saldaña-Díaz
AU - José Luis Pais-Brito
PY - 2026
DA - 2026/10/01
JO - Journal of clinical medicine
DO - 10.3390/jcm15197721
UR - https://europepmc.org/article/PMC/PMC13666259
AB - Background/Objectives: Robotic-assisted total hip arthroplasty (raTHA) improves the accuracy and reproducibility of acetabular component positioning compared with conventional THA (cTHA), but whether this translates into superior patient-reported outcomes and satisfaction remains debated. Methods: A retrospective comparative cohort study was performed, including all patients who underwent primary raTHA with the Mako system at our institution (September 2024–May 2025) and an equal-sized control group recruited consecutively from an alphabetically ordered list of 172 eligible cTHAs, starting from a randomly selected letter (August 2022–January 2025), with a minimum follow-up of one year. Treatment allocation was determined by insurance coverage. The postoperative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was the primary outcome; the Visual Analog Scale (VAS), modified Harris Hip Score (mHHS) and Forgotten Joint Score-12 (FJS-12) were secondary outcomes, and an overall satisfaction rating and willingness to undergo the surgery again were also recorded. Results: Ninety-three raTHA and 93 cTHA patients were analyzed. Follow-up was longer in the cTHA group (35.6 vs. 15.5 months; p < 0.001). Postoperative WOMAC (10.5 vs. 14.4; mean difference −3.8 points, 95% CI −7.4 to −0.2) and mHHS (86.9 vs. 84.7; mean difference 2.2 points, 95% CI −0.9 to 5.4) differed in rank-based comparisons, favoring raTHA (Mann–Whitney U test, p = 0.020 and p = 0.030, respectively). Point estimates were below the selected clinical-relevance thresholds, but the confidence intervals did not exclude clinically relevant differences; improvement from baseline did not differ between groups. There were no significant differences in VAS, FJS-12, overall satisfaction (9.32 vs. 9.31) or willingness to undergo surgery again (96.8% vs. 97.8%). Conclusions: Given insurance-based allocation, unequal follow-up and unadjusted analyses, robotic-assisted THA was associated with small differences in postoperative WOMAC and mHHS, whose point estimates were below the selected thresholds, although clinically relevant differences cannot be excluded; there were no differences in improvement, pain, joint awareness or satisfaction, which was very high in both groups. These findings do not establish a causal effect of robotic assistance; prospective randomized studies are needed.
SN - 2077-0383
ER -