Short-term outcomes of robotic-assisted direct anterior THA in patients with generalised ligamentous laxity: a propensity-matched study.

BACKGROUND: Generalised ligamentous laxity (GLL) has been linked to instability and implant failure in primary total hip arthroplasty (THA). This study assessed outcomes of GLL patients undergoing robotic-assisted direct anterior approach (DAA) THA.

METHODS: Retrospectively analysed prospectively collected data from patients who had robotic-assisted primary DAA THA between August 2013 and October 2022, with a minimum 2-year follow-up. Eligible patients completed at least one patient-reported outcome measure (PROMs): modified Harris Hip Score (mHHS), Hip disability and Osteoarthritis Outcome Score for Joint Replacement (HOOS-JR), Forgotten Joint Score (FJS), visual analogue scale (VAS), and satisfaction. Patients with GLL (Beighton ⩾4) were matched 1:2 to controls (Beighton ⩽3) by age, sex, BMI, and follow-up. Outcomes included PROMs changes, achievement of MCID/PASS, complications, and revisions.

RESULTS: Of 126 patients, 42 had GLL and 84 were controls. Both groups showed significant improvements in PROMs, high satisfaction, and similar achievement of MCID and PASS. Revision rates were comparable (p > 0.05): 1 GLL patient (2.4%) for infection and 1 control (1.2%) for aseptic loosening. No dislocations occurred.

CONCLUSIONS: GLL patients undergoing robotic-assisted DAA THA achieved favorable outcomes and survivorship comparable to controls, with no dislocations at minimum 2-year follow-up. Larger multicentre studies are needed to confirm whether this approach truly mitigates the higher dislocation and revision risk in the GLL populations.