MAKO robot-assisted total hip arthroplasty: a comprehensive meta-analysis of efficacy and safety outcomes

Abstract

Background: Introduction: Robotic surgery in total hip arthroplasty (THA) has emerged as a promising approach for improving precision and reducing errors. This meta-analysis aimed to compare the efficacy and safety of robot-assisted MAKO total hip arthroplasty. Methods: Studies were searched using four databases. Meta-analysis was performed using Review Manager 5.4. Efficacy was assessed radiologically, and functional scores and complications were recorded. Results: Twelve studies (1224 hips) were analyzed. The MAKO group achieved greater cup anteversion (MD 1.53, 95%CI 1.04–2.03) and a higher percentage of components within safe inclination and anteversion ranges (p > 0.05). Harris Hip Scores did not differ significantly (MD 0.61, 95%CI -0.22–1.45) but the forgotten joint scores favored MAKO (MD 5.99, 95% CI 4.10–7.88), although not exceeding the minimally clinically significant difference. No differences in intraoperative complications emerged (OR 0.96, 95%CI 0.51–1.79) but preoperative plans significantly mismatched the final cup placement after MAKO (p < 0.05). Conclusions: The use of the MAKO robot in THA improves radiological outcomes by enhancing safe prosthesis placement. However, no significant differences were observed in terms of complications. Longer follow-up studies are required to assess the clinical impact of improved radiological results. Level of evidence: Level IV metaanalysis of nonrandomized clinical trials. Registration: CRD42023433733