Technology-assisted Total Hip Arthroplasty: A Contemporary Analysis of Regional Trends, National Trends, and 90-day Outcomes in a Nationwide Cohort

Authors

• Amy Y. Zhao, Department of Orthopaedic Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
• Alex Gu, Department of Orthopaedic Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
• Gireesh Reddy, Department of Orthopaedic Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
• Bryant M. Song, Department of Orthopaedic Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
• Ilya Bendich, Department of Orthopaedic Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
• Andrew M. Schneider, Department of Orthopaedic Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.

Document Type

Journal Article

Publication Date

4-1-2026

Journal

Arthroplasty today

Volume

38

DOI

10.1016/j.artd.2025.101949

Keywords

Computer navigation; Outcomes; Robotic; Technology-assisted; Total hip arthroplasty; Trends

Abstract

BACKGROUND: Technology-assisted total hip arthroplasty (THA)-including computer-navigated and robotic-assisted techniques-has emerged as a strategy to enhance component alignment and potentially improve postoperative outcomes. Although prior studies have described increasing utilization, contemporary trends and associated complication rates remain underexplored. METHODS: A retrospective cohort study was conducted using a large national database to identify patients who underwent primary elective THA between 2010 and 2023. Patients were stratified into conventional vs technology-assisted THA groups, with the latter defined by the use of computer navigation or robotic assistance. Annual utilization trends were evaluated using linear regression, and 90-day postoperative complications were compared using multivariate logistic regression after adjusting for demographic, clinical, and regional factors. RESULTS: Among 1,062,597 patients undergoing primary elective THA, 4% received technology-assisted procedures. Utilization increased from 1.2% in 2010 to 12% in 2023-a 927% relative increase. Regional variation was notable, with highest utilization in the Northeast and the lowest in the Midwest. Technology-assisted THA was associated with lower odds of 90-day complications (5.36% vs 6.26%; adjusted odds ratio [OR]: 0.77; 95% confidence interval [CI]: 0.75-0.80), particularly reduced odds of dislocation (OR: 0.64; 95% CI: 0.60-0.69) and periprosthetic joint infection, though with higher odds of wound dehiscence (OR: 1.15; 95% CI: 1.07-1.23). CONCLUSIONS: Utilization of technology-assisted THA has increased substantially across the United States, accompanied by improved short-term outcomes, most notably decreased dislocation. These findings support the potential clinical benefits of surgical technology in THA, while underscoring the need for ongoing evaluation of long-term results.

APA Citation

Zhao, Amy Y.; Gu, Alex; Reddy, Gireesh; Song, Bryant M.; Bendich, Ilya; and Schneider, Andrew M., "Technology-assisted Total Hip Arthroplasty: A Contemporary Analysis of Regional Trends, National Trends, and 90-day Outcomes in a Nationwide Cohort" (2026). GW Authored Works. Paper 9178.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/9178

Department

School of Medicine and Health Sciences Resident Works