| アブストラクト | 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. |
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| 投稿者 | Tanaka, Hidetatsu; Tarasawa, Kunio; Mori, Yu; Kurishima, Hiroaki; Kawamata, Hiroki; Fushimi, Kiyohide; Fujimori, Kenji; Aizawa, Toshimi |
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| 組織名 | Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine,;Sendai, Japan. hidetatsu.tanaka.c7@tohoku.ac.jp.;Department of Health Administration and Policy, Tohoku University Graduate School;of Medicine, Sendai, Japan.;Sendai, Japan.;Department of Orthopaedic Surgery, Japanese Redcross Sendai Hospital, Sendai,;Japan.;Department of Health Policy and Informatics, Institute of Science Tokyo, Tokyo, |
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