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.
Similar content being viewed by others
References
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
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 92–99
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
Ryan C, Price V, John P et al (2010) Kasabach-Merritt phenomenon: a single centre experience. Eur J Haematol 84:97–104
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
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
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
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
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
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
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
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
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
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 3.0
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
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
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
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
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
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
Beringer DC, Patel JJ, Bozic KJ (2007) An overview of economic issues in computer-assisted total joint arthroplasty. Clin Orthop Relat Res 463:26–30
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
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.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material
ESM 1
(DOCX 15 kb)
Rights and permissions
About this article
Cite this article
Gausden, E.B., Popper, J.E., Sculco, P.K. et al. Computerized navigation for total hip arthroplasty is associated with lower complications and ninety-day readmissions: a nationwide linked analysis. International Orthopaedics (SICOT) 44, 471–476 (2020). https://doi.org/10.1007/s00264-019-04475-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00264-019-04475-y