Does robotic-assisted unicompartmental knee arthroplasty have lower complication and revision rates than the conventional procedure? A systematic review and meta-analysis

Sun, Yifeng; Liu, Wei; Hou, Jian; Hu, Xiuhua; Zhang, Wenqiang

doi:10.1136/bmjopen-2020-044778

Cited by 11 publications

(6 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies examining outcomes after UKA have shown improvements in complications with robotic assistance. 14 Regarding TKA complications, our finding of increased rates of complications when using conventional instrumentation parallels other previous large-database studies. 28,29 Small differences between groups mean that some published data on smaller cohorts have not identified these differences, possibly because of inadequate power.…”

Section: Discussionsupporting

confidence: 86%

“…Although some studies have found improved complication rates with computer-assisted patellofemoral arthroplasty and unicompartmental knee arthroplasty (CA-UKA), others have found no difference. 12–15 There are minimal data regarding outcomes of computer-assisted patellofemoral arthroplasty and computer-assisted bicompartmental knee arthroplasty (CA-BKA). 16–18…”

mentioning

confidence: 99%

See 1 more Smart Citation

Reduced Early Revision Surgery and Medical Complications in Computer-assisted Knee Arthroplasty Compared With Non–computer-assisted Arthroplasty

Malyavko

Cohen

Fuller

et al. 2022

J Am Acad Orthop Surg

View full text Add to dashboard Cite

Background:Computer assistance can help surgeons achieve mechanical accurate alignment, but the clinical effect of this technology in different arthroplasty types remains controversial because of conflicting functional outcomes, revision rates, and complication rates. The goal of this study was to compare 90-day medical complications and 1 and 2-year revision surgeries after computer-assisted patellofemoral arthroplasty, unicompartmental knee arthroplasty (CA-UKA), bicompartmental knee arthroplasty (CA-BKA), and total knee arthroplasty (CA-TKA) with non-computer-assisted procedures.Methods:A retrospective cohort analysis was conducted using the Mariner data set of the PearlDiver Patient Records Database from 2010 to 2018. Current Procedural Terminology codes were used to identify patients who underwent patellofemoral arthroplasty, unicompartmental knee arthroplasty, bicompartmental knee arthroplasty, and total knee arthroplasty with or without computer assistance for osteoarthritis. All included patients were followed up for 2 years. Univariate and multivariable analyses were conducted.Results:On multivariable analysis, revision within 1 year was decreased in patients who underwent computer-assisted patellofemoral arthroplasty (odds ratio [OR]: 0.541, P = 0.031), CA-UKA (OR: 0.798, P = 0.019), and computer-assisted bicompartmental knee arthroplasty (OR: 0.186, P = 0.025) compared with the same surgeries without technology assistance. CA-TKA had decreased odds of revision for aseptic loosening at 2 years (OR: 0.789, P < 0.001). CA-UKA and CA-TKA had decreased risk of overall 90-day medical complications (OR: 0.838, P < 0.001; OR: 0.903, P < 0.001, respectively) and major complications (OR: 0.750, P = 0.004; OR: 0.822, P < 0.001, respectively).Discussion:Complication rates and revision surgeries for all arthroplasty types were equivalent or more favorable when computer assistance was used during surgery. Our results quantify some early benefits to using computer assistance in total and partial knee arthroplasties.

show abstract

Section: Discussionsupporting

confidence: 86%

mentioning

confidence: 99%

Reduced Early Revision Surgery and Medical Complications in Computer-assisted Knee Arthroplasty Compared With Non–computer-assisted Arthroplasty

Malyavko

Cohen

Fuller

et al. 2022

J Am Acad Orthop Surg

View full text Add to dashboard Cite

show abstract

“…These are the imageless, handheld robotics, which allow for real-time planning and gap assessment, optimized alignment and balance, robotic-assisted bone resection upon a surgeon control in the most optimized, individualized manner. Constantly, the results do not encourage that ra-TKA systems present better intraoperative and postoperative outcomes and facilitate quicker return to activity than mTKA [ 18 , 19 , 20 , 21 , 22 , 23 ]. However, the literature lacks systematic reviews or meta-analyses to compare intraoperative (surgical time, tourniquet time, operative time and blood loss) and postoperative (KOOS, VAS, ROM, function, complications, revisions and return to activity) outcomes of the NAVIO versus CORI versus mTKA.…”

Section: Introductionmentioning

confidence: 95%

Robotic-Assisted Total Knee Arthroplasty Utilizing NAVIO, CORI Imageless Systems and Manual TKA Accurately Restore Femoral Rotational Alignment and Yield Satisfactory Clinical Outcomes: A Randomized Controlled Trial

et al. 2023

View full text Add to dashboard Cite

Background and objectives: The introduction of novel techniques in total knee arthroplasty (TKA) aiming to enhance outcomes and satisfaction of the procedure is constantly ongoing. In order to evidence a priority of one, we have conducted a randomized controlled trial with the aim of comparing patient-reported functional outcomes, radiographic outcomes and intraoperative measures between imageless (NAVIO and CORI), robotic-assisted (ra)- TKA (ra-TKA) and manual TKA (mTKA) for primary knee osteoarthritis (KOA). Materials and Methods: A total of 215 patients with the diagnosis of KOA of the knee were randomly assigned to one of the three groups: NAVIO (76 patients) or CORI (71 patients) robotic-assisted TKA, or manual technique (68 patients) TKA. The primary outcome (Knee Injury and Osteoarthritis Outcome Study [KOOS]), Visual Analogue Scale (VAS), Range of motion (ROM), femoral component rotational alignment and the secondary outcomes (surgery time, blood loss, complications, and revision at 12 months after surgery) were compared between three groups. KOOS and VAS were collected at particular follow up visits from each patient individually and ROM in flexion and extension was assessed during the physical examination. Femoral component rotational alignment was measured on the CT scan performed postoperatively utilizing the Berger’s method. Statistical significance was set at p < 0.05. Results: Both the ra-TKA groups and mTKA group displayed significant improvements in the majority of the functional outcome scores at 12 months. Despite having more prominent surgery time (NAVIO: mean +44.5 min in comparison to mTKA and CORI: mean +38.5 min in comparison to mTKA), both NAVIO and CORI tend to achieve highly accurate femoral component rotational alignment with mean radiographic scores in NAVIO vs. CORI vs. mTKA of 1.48° vs. 1.33° vs. 3.15° and lower blood loss (NAVIO: 1.74; CORI: 1.51; mTKA: 2.32. Furthermore, the investigation revealed the significant difference in femoral component rotational alignment between mTKA—NAVIO and mTKA—CORI and significantly different KOOS scores in NAVIO vs. CORI vs. mTKA of 87.05 vs. 85.59 vs. 81.76. Furthermore, the KOOS analysis showed between group significant statistical differences, but did not reach minimal clinically significant difference. There were no differences in postoperative ROM and VAS. There were no differences in complications between groups. Conclusions: To achieve a successful TKA, the precise tool and individualised objective is of great importance. The results suggest satisfactory results after both ra-TKA methods and mTKA. Ra-TKA and mTKA stand for a safe and reliable treatment method for OA. Patients reported excellent alleviation in functional outcomes and the radiological results revealed that the better precision does not necessarily lead to a better outcome. Therefore, ra-TKA does not imply strong enough advantages in comparison to the manual method, especially in terms of cost-efficiency and surgical time.

show abstract

“…Previous literature analyses showed controversial findings. A meta-analysis conducted by Zhang et al 40 reported a significantly reduced complication rate in R-UKA, and another meta-analysis published by Sun et al 53 showed significantly inferior complication and revision rates in R-UKA, while Chin et al 39 and Fu et al 49 were not able to find robotic assistance advantages in terms of complications and revisions. The present meta-analysis found a considerable difference between R-UKA and C-UKA in terms of complications and revisions, with C-UKA showing both complication and revision rates almost twice as high compared to R-UKA (10.1% vs 5.2% and 7.2% vs 4.1%, respectively).…”

Section: Discussionmentioning

confidence: 99%

Robotic-assisted unicompartmental knee arthroplasty improves functional outcomes, complications, and revisions

Bensa,

Sangiorgio,

Deabate

et al. 2024

Bone Jt Open

View full text Add to dashboard Cite

AimsRobotic-assisted unicompartmental knee arthroplasty (R-UKA) has been proposed as an approach to improve the results of the conventional manual UKA (C-UKA). The aim of this meta-analysis was to analyze the studies comparing R-UKA and C-UKA in terms of clinical outcomes, radiological results, operating time, complications, and revisions.MethodsThe literature search was conducted on three databases (PubMed, Cochrane, and Web of Science) on 20 February 2024 according to the guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Inclusion criteria were comparative studies, written in the English language, with no time limitations, on the comparison of R-UKA and C-UKA. The quality of each article was assessed using the Downs and Black Checklist for Measuring Quality.ResultsAmong the 3,669 articles retrieved, 21 studies on 19 series of patients were included. A total of 3,074 patients (59.5% female and 40.5% male; mean age 65.2 years (SD 3.9); mean BMI 27.4 kg/m2 (SD 2.2)) were analyzed. R-UKA obtained a superior Knee Society Score improvement compared to C-UKA (mean difference (MD) 4.9; p < 0.001) and better Forgotten Joint Score postoperative values (MD 5.5; p = 0.032). The analysis of radiological outcomes did not find a statistically significant difference between the two approaches. R-UKA showed longer operating time (MD 15.6; p < 0.001), but reduced complication and revision rates compared to C-UKA (5.2% vs 10.1% and 4.1% vs 7.2%, respectively).ConclusionThis meta-analysis showed that the robotic approach for UKA provided a significant improvement in functional outcomes compared to the conventional manual technique. R-UKA showed similar radiological results and longer operating time, but reduced complication and revision rates compared to C-UKA. Overall, R-UKA seems to provide relevant benefits over C-UKA in the management of patients undergoing UKA.Cite this article: Bone Jt Open 2024;5(5):374–384.

show abstract

Does robotic-assisted unicompartmental knee arthroplasty have lower complication and revision rates than the conventional procedure? A systematic review and meta-analysis

Cited by 11 publications

References 32 publications

Reduced Early Revision Surgery and Medical Complications in Computer-assisted Knee Arthroplasty Compared With Non–computer-assisted Arthroplasty

Reduced Early Revision Surgery and Medical Complications in Computer-assisted Knee Arthroplasty Compared With Non–computer-assisted Arthroplasty

Robotic-Assisted Total Knee Arthroplasty Utilizing NAVIO, CORI Imageless Systems and Manual TKA Accurately Restore Femoral Rotational Alignment and Yield Satisfactory Clinical Outcomes: A Randomized Controlled Trial

Robotic-assisted unicompartmental knee arthroplasty improves functional outcomes, complications, and revisions

Contact Info

Product

Resources

About