VOLUME 6 - NUMBER 2 - 2026
Is computer-navigated and robot-assisted total hip replacement superior
to the conventional freehand technique? A review of the last decade
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Marta Massenzi, Davide Stimolo, Roberto Civinini, Matteo Innocenti
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Concise reviews, 84-86
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Full text PDF
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Background: Total hip arthroplasty (THA) is a highly successful procedure, yet postoperative dislocation remains a significant cause of early revision surgery. Accurate acetabular component positioning is critical to minimize instability, particularly in patients with altered spinopelvic mechanics. Computer-navigated and robot-assisted technologies have been introduced to improve surgical precision; however, whether increased radiographic accuracy translates into superior clinical outcomes remains unclear. Methods: A literature review of PubMed and Embase was conducted in January 2026, including English-language studies published between 2016 and 2026 comparing computer-navigated or robot-assisted THA with conventional freehand THA. Clinical trials, prospective and retrospective cohort studies, and case-control studies were included. Results: Computer-assisted techniques consistently demonstrate improved acetabular component positioning accuracy. However, most comparative studies show no significant reduction in dislocation or overall revision rates. Large database analyses report minimal differences in short- to mid-term clinical outcomes. Operative time is frequently increased with computer-assisted procedures. Long-term survivorship data remain limited. Conclusions: Although computer-navigated and robot-assisted THA improve radiographic precision, current evidence does not demonstrate consistent superiority in clinical outcomes or revision rates compared with the conventional technique. High-quality long-term studies and cost-effectiveness analyses are needed.
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KEY WORDS: THA, computer-navigated, robotics-assisted, total hip replacement, total hip arthroplasty.
