Robotic hip replacement: fewer dislocation revisions, same overall revision

Design

Retrospective registry cohort with Medicare linkage, mixed-effects Cox models

Population

124,465 primary THAs in people aged ≥65 (10,988 robot-assisted)

Primary outcome

All-cause revision and revision for dislocation at 2 years

Effect

All-cause HR 0.9 (0.7–1.1); dislocation revision HR 0.5 (0.3–0.9)

A registry study published in June 2026 used the American Joint Replacement Registry linked to Medicare claims to compare 10,988 robot-assisted and 113,477 conventional primary total hip arthroplasties in people aged 65 or older (2017–2021), adjusting for patient factors and clustering by surgeon and hospital.

At two years, all-cause revision did not differ (1.9% vs 2.1%; HR 0.9, 95% CI 0.7 to 1.1). Revision for dislocation was lower with robotic assistance (0.3% vs 0.6%; HR 0.5, 0.3 to 0.9).

The absolute difference is about three revisions per 1,000 hips. Surgeons who adopt robots early may differ from those who do not in ways adjustment cannot capture, and two years is short for implant survival.

For most hips, robotic assistance does not change the revision outlook. Where dislocation risk is the main concern, such as abnormal spinopelvic mobility, it may be worth considering where available.

• Do not expect robotic assistance to lower overall revision at two years.
• Consider it where dislocation risk is a particular concern and the technology is available.
• Explain to patients that the dislocation benefit is about three per 1,000 hips.
• Await longer follow-up before treating it as standard.

Why it matters

It narrows the case for robots to dislocation risk, a specific and modest benefit.

Don't overread it

Observational registry data; surgeon selection may explain part of the difference.

The statistics, in plain English

A hazard ratio of 0.5 sounds large, but it halves a small risk: 6 per 1,000 down to 3 per 1,000. The all-cause interval from 0.7 to 1.1 includes no effect.

Read the rest in the app

You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.

Get Daily Doctor — free

Scan to keep reading on your phone. No account needed to start.