Safety and efficacy of orthopedic robots in total hip arthroplasty: a network meta-analysis and systematic review

摘要

BACKGROUND: With the increasing demand for total hip arthroplasty (THA) and the inevitable trend of orthopedic robots and artificial intelligence in the future, it is necessary to explore the safety and effectiveness of orthopedic robots in THA. Currently, most orthopedic robots are in the early stages of development, and evaluating their clinical efficacy can assist in making informed decisions for practical use. OBJECTIVE: To explore the advantages of 7 types of robot-assisted THA with respect to 5 indicators. METHODS: Literature from databases such as CNKI, PubMed, and Web of Science was retrieved up to July 17, 2024. Literature evaluation was conducted via Review Manager 5.4, and a network meta-analysis was performed via RStudio (version 4.4.1). RESULTS: A total of 17 studies involving 1741 patients were included. In direct comparisons, the operation time was longer for MAKO (MD = 19; CI = 6.7, 31), TRex (MD = 37, CI = 20, 54) and YUANHUA (MD = 35, CI = 4.2, 66) than for C-THA. The leg length discrepancy (LLD) was smaller for TRex (MD = -3.4, CI = -6.6, -0.36) and RO (MD = -4.3, CI = -8.7, -0.064) than for C-THA. In the comprehensive best probability ranking, operation time [C-THA (96%) > TJ (68%) > RO (53.2%) > MAKO (53%) > LA (45%) > YU (21%) > TR (13%)], blood loss [TJ (89%) > C-THA (50%) > LA (49%) > YU (42%) > MAKO (20%)], LLD [RO (83%) > TR (75%) > MAKO (61%) > TJ (51%) > YU (43%) > JJ (40%) > C-THA (24%) > LA (22%)], HHS [RO (65%) > C-THA (55%) > LA (51%) > TR (50%) > JJ (48%) > YU (46%) > MAKO (37%)], and infection [TJ (77%) > C-THA (67%) > MAKO (44%) > RO (10%)]. CONCLUSION: Each of the seven types of RA-THA and C-THA has its own advantages, with TJ and RO RA-THA being slightly more prominent. Overall, in terms of safety and effectiveness, RA-THA is generally superior to C-THA, although further development is still needed.