DOI: 10.1177/11207000261467654 ISSN: 1120-7000

Robotic-assisted versus conventional total hip arthroplasty in Crowe Type 3–4 developmental dysplasia of the hip: a single-centre retrospective comparative cohort study

Murat Kezer, Kayhan Turan, İsmet Yalkın Çamurcu, Semih Ak, Onur Gültekin
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Aim:

The aim of this study was to compare the radiographic accuracy, clinical outcomes, and complications of robotic-assisted total hip arthroplasty (rTHA) and conventional total hip arthroplasty (cTHA) in patients with Crowe type 3–4 developmental dysplasia of the hip (DDH).

Methods:

This single-centre retrospective comparative study included 38 patients with Crowe type 3–4 DDH who underwent total hip arthroplasty (THA) between 2016 and 2021 (20 rTHA, 18 cTHA). Clinical outcomes were evaluated using the Harris Hip Score (HHS). Acetabular cup inclination, anteversion, leg-length discrepancy (LLD), operative time, and complications were assessed at a mean follow-up of 32.0 ± 15.7 months in the rTHA group and 35.9 ± 19.0 months in the cTHA group.

Results:

Acetabular anteversion and inclination were comparable between groups ( p  = 0.099 and p  = 0.231). The proportion of cups within the Lewinnek safe zone was higher in the rTHA group (90% vs. 77%), without statistical significance ( p  = 0.302). No significant differences were observed in postoperative LLD or HHS. Operative time was significantly longer in the rTHA group (109.7 ± 33.6 vs. 93.5 ± 21.3 minutes, p  = 0.042). Complication rates were similar between groups (2 vs. 2 cases).

Conclusions:

rTHA and cTHA demonstrated comparable radiographic and clinical outcomes in Crowe type 3-4 DDH at short- to mid-term follow-up. Although rTHA showed a trend toward improved implant positioning, operative time was longer. Larger prospective studies are required to determine potential long-term advantages of rTHA in severe DDH.

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