(P 266) LONG STEM CEMENTED ROBTIC ARM-ASSISTED TOTAL HIP ARTHROPLASTY: OUTCOMES IN PATIENTS WITH PRIOR ONCOLOGIC DISEASE

Objective: The proximal femur is a common site of primary or metastatic oncologic disease. Extent of bony disease and adjacent soft tissue extension can make performing a total hip arthroplasty (THA) on these patients difficult. The Mako robotic arm-assisted total hip arthroplasty (RATHA) utilizes preoperative CT scans to guide the intraoperative placement of components, potentially decreasing the complexity of the cases with deformed anatomy. This study aims to share our experience and outcomes in patients with oncologic disease undergoing RATHA.

Methods: A retrospective review was conducted that included patients who underwent Mako RATHA from September 2020 to November 2023. All patients included have either a primary bone tumor, or other oncologic history affecting the hip. Patient demographics, pain scores, clinical outcomes, and complications were analyzed.

Results: Nineteen patients (M=73.7%, n=14) with an average age of 67.6+/-10.2 years (range=51.4-89.9) and BMI of 27.6+/-5.1 kg/m2 (range=19-37.4) were included.
Median follow-up time was 77+/-52.1 weeks (range=2-185). The left hip was slightly more commonly operated on than the right (n=11 vs 8; 57.9% vs 42.1%). 31.6% (n=6) of patients had a prior surgery on the ipsilateral hip. All patients had a history of significant osteoarthritis of the affected hip. Most common previous oncologic histories included metastatic cancer (n=8), multiple myeloma (n=3), and multiple hereditary exostoses (n=2). Excluding one outlier (18 days), the average length of stay (LOS) was 3.3+/-1.6 days (range=1-8). There were no intraoperative complications. Postoperative complications include 2 patients who suffered a pulmonary embolism. Visual analog pain scores decreased from an average of 6.0 preoperatively to 2.2 postoperatively. There were no neurovascular complications or reoperations.

Conclusion: Patients with previous oncologic history who underwent total hip arthroplasty with the assistance of the Mako robot had fantastic clinical outcomes and reduced pain at longest follow up.