A Retrospective Comparison of Functional Outcomes of Robotic-Assisted and Conventional Unicompartmental Knee Arthroplasty

INTRODUCTION: Unicompartmental knee arthroplasty (UKA) is effective for alleviating symptoms of arthritis in a single knee compartment; however, errors in alignment and instability may predispose to failure. Robotic technology has improved precision, but its impact on functional recovery after UKA remains unknown. The purpose of this study was to compare early functional recovery, pain, and radiographic alignment in UKA performed with either robotic assistance or conventional methods.METHODS: All consecutive patients undergoing UKA by a single physician from January 2015 to March 2018 were retrospectively reviewed. Lower Extremity Functional Scale (LEFS), KOOS Jr, and VAS (0-10) outcomes scores were collected preoperatively, 1, 6, and 12 weeks postoperatively. Radiographic alignment was assessed at the initial postoperative visit.RESULTS: There were 161 patients, 65 conventional and 96 robotic. At baseline, there was no difference in average age, BMI, or outcomes scores between the two groups. Average preoperative pain was significantly higher in conventional patients (6.1 vs. 5.4; p=0.04). At 3 weeks post-op, conventional UKA patients still had significantly higher pain levels (3.9 vs. 3.1; p=.02). Both groups showed significant improvement in LEF (p<.0001) scores over time (p<.0001). Significant improvement in KOOS Jr. scores from pre-op (52.3) to 6 and 12-weeks postoperatively (67.6, 69.8; p<0.001). When comparing PCS of the VR/SF-12, the robotic-assisted group had significantly higher improvement compared to the conventional group at 6-weeks (40.6 vs. 35.6; p=0.02).CONCLUSION: Robotic assisted UKA resulted in fewer radiographic outliers, and more rapid recovery with less early postoperative pain although functional differences tended to equilibrate by 3 months postoperatively.

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Robotic Assistance in Unicompartmental Knee Arthroplasty Results in Superior Early Functional Recovery and Is More Likely to Meet Patient Expectations

Advances in Orthopedics ◽

10.1155/2021/4770960 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Meredith P. Crizer ◽

Amer Haffar ◽

Andrew Battenberg ◽

Mikayla McGrath ◽

Ryan Sutton ◽

...

Keyword(s):

Functional Recovery ◽

Knee Arthroplasty ◽

Unicompartmental Knee Arthroplasty ◽

Mixed Model ◽

Functional Score ◽

Robotic Assistance ◽

Pain Scores ◽

Unicompartmental Knee ◽

Implant Alignment ◽

Early Functional Recovery

Robotic technology has reduced the errors of implant alignment in unicompartmental knee arthroplasty (UKA), but its impact on functional recovery after UKA is poorly defined. The purpose of this study was to compare early functional recovery, pain levels, and satisfaction in UKA performed with either robotic assistance or conventional methods. A retrospective analysis was performed on 89 matched consecutive patients who underwent outpatient UKA by a single physician using either conventional instruments (n = 39) or robotic methods (n = 50), with otherwise identical perioperative protocols. Outcomes studied included Lower Extremity Functional Score (LEFS), new Knee Society Score (KSS), Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR.), VR/SF-12, Visual Analog Scale (VAS) pain scores, and perioperative opioid consumption. Patients in the robotic cohort had superior early functional outcomes, with greater LEFS (conventional = 23; robotic = 31) at 1 week post-op p = 0.015 and KOOS-JR (conventional = 74; robotic = 81) at up to 6 months post-op p = 0.037 ; these two values remained statistically significant after mixed-model regression analysis p = 0.010 ; p = 0.023 , respectively. At 1 year post-op, expectations were more likely to be met in those who received robotic assistance p = 0.06 . No differences were reported with respect to postoperative opioid usage p = 0.320 , reoperations p = 1.00 , and complications p = 0.628 . Robotic-assisted UKA resulted in more rapid recovery and less early postoperative pain and were more likely to meet expectations than conventional UKA, although functional differences equilibrated by 1 year postoperatively. Further follow-up is necessary to determine if implant durability is impacted by robotics.

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Comparing clinical and radiographic outcomes of robotic-assisted, computer-navigated and conventional unicompartmental knee arthroplasty: A network meta-analysis of randomized controlled trials

Journal of Orthopaedics ◽

10.1016/j.jor.2021.05.012 ◽

2021 ◽

Author(s):

Kyle N. Kunze ◽

Daniel Farivar ◽

Ajay Premkumar ◽

Michael B. Cross ◽

Alejandro Gonzalez Della Valle ◽

...

Keyword(s):

Randomized Controlled Trials ◽

Knee Arthroplasty ◽

Unicompartmental Knee Arthroplasty ◽

Meta Analysis ◽

Controlled Trials ◽

Robotic Assisted ◽

Randomized Controlled ◽

Radiographic Outcomes ◽

Unicompartmental Knee

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Is robotic-assisted unicompartmental knee arthroplasty a safe procedure? A case control study

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-020-06051-z ◽

2020 ◽

Cited By ~ 3

Author(s):

Guillaume Mergenthaler ◽

Cécile Batailler ◽

Timothy Lording ◽

Elvire Servien ◽

Sébastien Lustig

Keyword(s):

Knee Arthroplasty ◽

Unicompartmental Knee Arthroplasty ◽

Case Control Study ◽

Case Control ◽

Safe Procedure ◽

Robotic Assisted ◽

Unicompartmental Knee ◽

Control Study

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A systematic review of robotic-assisted unicompartmental knee arthroplasty

The Bone & Joint Journal ◽

10.1302/0301-620x.101b7.bjj-2018-1317.r1 ◽

2019 ◽

Vol 101-B (7) ◽

pp. 838-847 ◽

Cited By ~ 22

Author(s):

P. G. Robinson ◽

N. D. Clement ◽

D. Hamilton ◽

M. J. G. Blyth ◽

F. S. Haddad ◽

...

Keyword(s):

Systematic Review ◽

United Kingdom ◽

Knee Arthroplasty ◽

Unicompartmental Knee Arthroplasty ◽

Functional Outcomes ◽

Implant Design ◽

Current Evidence ◽

Robotic Assisted ◽

Implant Positioning ◽

Unicompartmental Knee

AimsRobotic-assisted unicompartmental knee arthroplasty (UKA) promises accurate implant placement with the potential of improved survival and functional outcomes. The aim of this study was to present the current evidence for robotic-assisted UKA and describe the outcome in terms of implant positioning, range of movement (ROM), function and survival, and the types of robot and implants that are currently used.Materials and MethodsA search of PubMed and Medline was performed in October 2018 in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. Search terms included “robotic”, “knee”, and “surgery”. The criteria for inclusion was any study describing the use of robotic UKA and reporting implant positioning, ROM, function, and survival for clinical, cadaveric, or dry bone studies.ResultsA total of 528 articles were initially identified from the databases and reference lists. Following full text screening, 38 studies that satisfied the inclusion criteria were included. In all, 20 studies reported on implant positioning, 18 on functional outcomes, 16 on survivorship, and six on ROM. The Mako (Stryker, Mahwah, New Jersey) robot was used in 32 studies (84%), the BlueBelt Navio (Blue Belt Technologies, Plymouth, Minnesota) in three (8%), the Sculptor RGA (Stanmore Implants, Borehamwood United Kingdom) in two (5%), and the Acrobot (The Acrobot Co. Ltd., London, United Kingdom) in one study (3%). The most commonly used implant was the Restoris MCK (Stryker). Nine studies (24%) did not report the implant that was used. The pooled survivorship at six years follow-up was 96%. However, when assessing survival according to implant design, survivorship of an inlay (all-polyethylene) tibial implant was 89%, whereas that of an onlay (metal-backed) implant was 97% at six years (odds ratio 3.66, 95% confidence interval 20.7 to 6.46, p < 0.001).ConclusionThere is little description of the choice of implant when reporting robotic-assisted UKA, which is essential when assessing survivorship, in the literature. Implant positioning with robotic-assisted UKA is more accurate and more reproducible than that performed manually and may offer better functional outcomes, but whether this translates into improved implant survival in the mid- to longer-term remains to be seen. Cite this article: Bone Joint J 2019;101-B:838–847.

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