Perceptions and attitudes regarding robotic total hip arthroplasty: a patient stakeholder survey

To describe the attitudes and preferences of patients pertaining to robotic-assisted total hip arthroplasty (RA-THA) with the long-term objective of designing a prospective randomized-controlled trial (RCT) to evaluate the efficacy of RA-THA compared to conventional technique. A cross-sectional survey of patients attending an outpatient high-volume academic arthroplasty clinic chosen was administered from December 2023 to May 2024. The survey comprised 31 items including patient demographic, patient reported factors of significance and perceptions surrounding RA-THA. Ninety-seven patients completed the survey with a mean age of 67.5 +/- 9.1 years and with 63% of patients being female. The majority of respondents were not at all familiar with RA-THA (69%). Common perceptions of RA-THA compared to conventional technique included a smaller incision (41%), lower chance of developing infection (47%), shorter length of surgery (41%), less blood loss (41%), lower cost (22%), shorter length of stay (30%), more precise implant positioning (46.8%), lower post-operative pain (29%), and lower post-operative complications (36%). Very important outcomes to be assessed in future investigations included post-operative range of motion (91%), implant longevity (91%), dislocation risk (90%), post-operative pain (89%), and infection risk (87%). Patient familiarity with robotic-assisted total hip arthroplasty is low. Patient perceptions regarding RA-THA compared to conventional technique are favorable, despite limited evidence to date. Important factors to be assessed in future RCTs include range of motion, implant longevity, dislocation risk, and infection risk. Findings of this study can inform a clinically relevant RCT assessing RA-THA compared to conventional technique.