To explore the clinical significance of intelligent preoperative planning based on the hip replacement robot-assisted system in the population of elderly patients undergoing artificial femoral head replacement for femoral neck fractures.

The data of the patients who accepted artificial femoral head replacement for unilateral femoral neck fracture from October 2019 to February 2022 in the Department of Bone and Joint, the Second Affiliated Hospital of Xi′an Jiaotong University were retrospectively analyzed. Pathological fractures, the fracture time longer than four weeks and severe osteoporosis were exluded. All the patients received the surgery with a posterolateral approach by the same group of surgeons using the same biological fixation prosthesis. Age, gender, body mass index (BMI), operation time, intraoperative blood loss, whether conducting preoperative planning or not, the size of preoperative planning and actual use of femoral stem prosthesis were recorded; the intraoperative periprosthesis fracture was determined according to the surgical records and postoperative X-ray. The types of fracture were determined by Vancouver classification. The patients were divided into two groups based on whether or not preoperative planning was performed; the baseline data, duration of surgery, intraoperative blood loss, and incidence of intraoperative periprosthetic fractures were compared between the two groups using independent samples t test and chi square test.

A total of 186 patients were included in this study, including 59 males and 127 females. The age was(84±4) years, average BMI was(23±4)kg/m^2, the operation time was(44±7)min, and the intraoperative blood loss was(265±45)ml. Sixty-two patients adopted preoperative planning before the surgery, and the femoral stem prostheses were successfully implanted according to the planned femoral stem models in 56 patients, while the actual implant models in six patients were inconsistent with the planned femoral stem models. Among the 186 patients, nine had periprosthesis fractures during the operation, one in the preoperative planning group and eight in the non-preoperative planning group. The operative time and the blood loss were less in the planned group than in the unplanned group (t=10.153, 11.412, both P<0.05). The incidence of intraoperative periprosthesis fractures in the planned group was lower than that in the unplanned group (1.6% vs.6.5%), but the difference was not statistically significant(P=0.227).

Preoperative planning based on robot-assisted system can effectively reduce operative time and intraoperative blood loss, and whether it can reduce the incidence of intraoperative periprosthesis fracture needs to be studied in a larger sample.