A new study from an international team of researchers—which won the President’s Choice award at the American Society of Regional Anesthesia and Pain Medicine meeting on May 2, 2025—titled: “Opioid Consumption During Hospitalization Across Manual, Computer- and Robotic-Assisted Total Hip Replacement,” found that robots lower opioid use.
Specifically, the investigators found that patients who had robotic-assisted total hip replacement (THR) needed less opioid medication during hospitalization than patients who had computer-assisted or manual THR. It is the first report of robot-assisted THA’s superiority over computer-assisted THA.
Co-author Periklis Giannakis, M.D., a research fellow at HSS, told OTW; “This study is aligned with the goals of our newly-established Pain Prevention Research Center at HSS, which has given us the unique opportunity for collaborations with other HSS services, including the Adult Reconstruction and Joint Replacement Service. With technology being increasingly adopted in THR, it is important to holistically evaluate all aspects of its impact in patient care.”
“Acute postoperative pain management is vital to the patient and its success has been linked to better long-term outcomes, functionality and overall satisfaction in observational studies. Given the gap in the medical literature, we aimed to evaluate the impact of THR modality choice in opioid requirements during hospitalization.”
100,000 Hip Replacement Cases
The study collected data from 100,000 hip replacement cases of which:
75,966 were manual THA,
6,207 were computer-assisted THA and.
17,497 were robot-assisted THA
The data collected indicated that robotic-assisted hip replacement was associated with the lowest total opioid consumption during hospitalization.
The authors noted that while the exact mechanism is unknown, reduced soft tissue trauma and a more precise robotic-assisted surgery may contribute to less acute inflammation and less pain immediately after the procedure.
Elaborating to OTW, Dr.Giannakis explained, “There is some retrospective evidence suggesting that using a robotic-assisted system might lead to less aggressive manipulation of the soft tissue that surrounds the hip joint and might require less aggressive maneuvers during acetabular reaming and cup placement. This could perhaps explain the lower opioid requirement we observed for patients undergoing robotic-assisted THR. However, more studies are needed to definitively prove this concept.”
“For this current study, further adjusted analyses are being conducted to adjust for more patient- and care-related confouding factors (e.g. anesthesia choice, multimodal analgesia) than originally included that could have influenced our results, in an effort to isolate the true impact of surgical modality choice.”
“Future prospective studies are currently designed in collaboration with other departments at HSS that we hope can help us confirm our results and elucidate the factors that are driving them.”
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