High Satisfaction, Modest Differences: A Comparative Cohort Study of Robotic-Assisted and Conventional Total Hip Arthroplasty

Background/Objectives: Robotic-assisted total hip arthroplasty (raTHA) improves the accuracy and reproducibility of acetabular component positioning compared with conventional THA (cTHA), but whether this translates into superior patient-reported outcomes and satisfaction remains debated.

Methods

A retrospective comparative cohort study was performed, including all patients who underwent primary raTHA with the Mako system at our institution (September 2024–May 2025) and an equal-sized control group recruited consecutively from an alphabetically ordered list of 172 eligible cTHAs, starting from a randomly selected letter (August 2022–January 2025), with a minimum follow-up of one year. Treatment allocation was determined by insurance coverage. The postoperative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was the primary outcome; the Visual Analog Scale (VAS), modified Harris Hip Score (mHHS) and Forgotten Joint Score-12 (FJS-12) were secondary outcomes, and an overall satisfaction rating and willingness to undergo the surgery again were also recorded.