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<p>Introduction: Computer-assisted (CA) surgery is increasingly adopted in total hip arthroplasty (THA) to enhance implant positioning accuracy. However, robust evidence regarding its impact on postoperative complications compared with manual THA (M-THA) remains limited. This study evaluated the association between CA-THA and early postoperative complications using a large Japanese database. Materials and Methods: We analyzed 336,624 THA cases recorded in the Japanese Diagnosis Procedure Combination (DPC) database between December 2011 and March 2023. Of these, 242,067 underwent M-THA and 94,557 underwent CA-THA. One-to-one propensity score matching was performed to adjust for age, sex, body mass index, comorbidities, and diagnosis. Outcomes included surgical complications, medical complications, and in-hospital mortality. Results: After matching, 93,887 patient pairs were analyzed. Compared with M-THA, CA-THA was associated with lower odds of dislocation (OR 0.667, 95% CI 0.556–0.786, <i>p</i> &lt; 0.001), infection (OR 0.763, 95% CI 0.687–0.848, <i>p</i> &lt; 0.001), and re-operation (OR 0.822, 95% CI 0.732–0.922, <i>p</i> &lt; 0.001), but higher odds of periprosthetic fracture (OR 1.301, 95% CI 1.118–1.514, <i>p</i> &lt; 0.001). No significant differences were found in medical complications or mortality. Conclusions: In this nationwide cohort, CA-THA was associated with reduced risks of dislocation, infection, and reoperation, but an increased risk of periprosthetic fracture compared with M-THA. Further research should clarify optimal indications and refine patient selection criteria for CA-THA. In this nationwide cohort, CA-THA was associated with reduced risks of dislocation, infection, and reoperation, but an increased risk of periprosthetic fracture compared with M-THA. Further research should clarify optimal indications and refine patient selection criteria for CA-THA.</p>

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Computer-assisted total hip arthroplasty reduces early complications based on Japanese nationwide medical claims data

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  • 发表日期：

    2025年11月12日

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  • Hidetatsu Tanaka,
  • Kunio Tarasawa,
  • Yu Mori,
  • Hiroaki Kurishima,
  • Hiroki Kawamata,
  • Kiyohide Fushimi,
  • Kenji Fujimori,
  • Toshimi Aizawa

摘要

Introduction: Computer-assisted (CA) surgery is increasingly adopted in total hip arthroplasty (THA) to enhance implant positioning accuracy. However, robust evidence regarding its impact on postoperative complications compared with manual THA (M-THA) remains limited. This study evaluated the association between CA-THA and early postoperative complications using a large Japanese database. Materials and Methods: We analyzed 336,624 THA cases recorded in the Japanese Diagnosis Procedure Combination (DPC) database between December 2011 and March 2023. Of these, 242,067 underwent M-THA and 94,557 underwent CA-THA. One-to-one propensity score matching was performed to adjust for age, sex, body mass index, comorbidities, and diagnosis. Outcomes included surgical complications, medical complications, and in-hospital mortality. Results: After matching, 93,887 patient pairs were analyzed. Compared with M-THA, CA-THA was associated with lower odds of dislocation (OR 0.667, 95% CI 0.556–0.786, p < 0.001), infection (OR 0.763, 95% CI 0.687–0.848, p < 0.001), and re-operation (OR 0.822, 95% CI 0.732–0.922, p < 0.001), but higher odds of periprosthetic fracture (OR 1.301, 95% CI 1.118–1.514, p < 0.001). No significant differences were found in medical complications or mortality. Conclusions: In this nationwide cohort, CA-THA was associated with reduced risks of dislocation, infection, and reoperation, but an increased risk of periprosthetic fracture compared with M-THA. Further research should clarify optimal indications and refine patient selection criteria for CA-THA. In this nationwide cohort, CA-THA was associated with reduced risks of dislocation, infection, and reoperation, but an increased risk of periprosthetic fracture compared with M-THA. Further research should clarify optimal indications and refine patient selection criteria for CA-THA.