Authors' objectives:

This study aims to review the effectiveness and cost-effectiveness of computer assisted hip and knee arthroplasty using navigation and robotic systems.

Authors' recommendations: Computer-assisted arthroplasty using navigation systems is considered to be in the investigational stage. To date, studies have only assessed short-term outcomes; long-term effectiveness (need for revision, implant longevity, pain, functional performance) has not been demonstrated. This is important because a Level 1 study that examined robotic-assisted arthroplasty compared to manual implantation concluded that despite advantages in surgical accuracy, the long-term effects included a higher revision and dislocation rate. Furthermore, at 24 months after surgery, there was no difference between the patients who underwent robotic-assisted and manual implantation in terms of functional hip scores. Computer-assisted arthroplasty using robotic systems is considered to be in the investigational stage and short-term outcomes seem promising. A Level 1 study revealed that there was no statistically significant difference between functional hip scores at 24 months post implantation between patients who underwent robotic-assisted primary hip arthroplasty and those that were treated with manual implantation. Robotic-assisted arthroplasty had advantages in terms of preoperative planning and the accuracy of the intraoperative procedure, however, patients had a higher dislocation rate and more revisions. Additional study is required to further address long-term effectiveness since it was suggested that the use of different prostheses may produce less muscle detachment in primary hip arthroplasty. The current large investigative studies of robotic-assisted arthroplasty underway in the United States to develop information for FDA licensing are awaited with interest. The robotic-assisted technology is not yet licensed by Health Canada or the USFDA.

Authors' methods: Systematic review

Project Status: Completed

Year Published: 2004

URL for published report: http://www.health.gov.on.ca/english/providers/program/mas/tech/reviews/pdf/rev_arthro_020104.pdf

URL for additional information: http://www.hqontario.ca/evidence/publications-and-ohtac-recommendations/ohtas-reports-and-ohtac-recommendations/computer-assisted-hip-and-knee-arthroplasty-navigation-and-robotic-systems

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Medical Advisory Secretariat

Contact Address: Medical Advisory Secretariat, 20 Dundas Street West, 10th Floor, Toronto, ON M5G 2N6 CANADA. Tel: 416-314-1092l; Fax: 416-325-2364;

Contact Name: MASinfo.moh@ontario.ca

Contact Email: MASinfo.moh@ontario.ca

Copyright: Medical Advisory Secretariat, Ontario Ministry of Health and Long-Term Care