Early Superior Clinical Outcomes in Robotic-Assisted TKA Compared to Conventional TKA in the Same Patient: A Comparative Analysis

Abstract

Robotic-assisted total knee arthroplasty (RA-TKA) has demonstrated improved alignment and outcome scores when compared with manual total knee arthroplasty (M-TKA); however, few studies compare differences in the same patient. This study is a retrospective review that assesses clinical outcomes of 36 patients who underwent a primary RA-TKA and had undergone a prior contralateral M-TKA. All surgeries were performed by a single surgeon at the same institution. Patients were assessed for differences in hospital length of stay, improvement in pre- versus postoperative range of motion, Knee Injury and Osteoarthritis Outcome Score (KOOS), and Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores. Student's t-test and Fisher's exact test were utilized to detect significant differences. Patient demographics showed a mean age of 64.5, 24 females (67%), and mean body mass index of 35.1 ± 5.7. The average follow-up time was 2.9 years for M-TKA and 1.3 years for RA-TKA. Hospital length of stay was decreased by 5.5 hours for RA-TKA (p = 0.03). Total postoperative WOMAC score was not statistically different between RA-TKA and M-TKA (p = 0.061); however, pain and stiffness components were statistically improved in RA-TKA (p = 0.041 and p = 0.007), respectively. KOOS was higher in RA-TKA, which approached statistical significance (p = 0.005). Pre- versus postoperative knee flexion improved significantly in both cohorts. There was a significant difference in pre- versus postoperative range of motion at 3, 6, and 12 months follow-up after RA-TKA in comparison to M-TKA (p < 0.05). There were no postoperative complications. Patients who underwent RA-TKA demonstrated early improvement at 1-year follow-up in pain, stiffness, and knee flexion when compared with their prior contralateral M-TKA. There was a significant decrease in postoperative length of stay by 5.5 hours in the RA-TKA group. Limitations include a small sample size and differences in follow-up times between RA-TKA and M-TKA

Robotic‐arm assisted total knee arthroplasty is associated with comparable functional outcomes but improved forgotten joint scores compared with conventional manual total knee arthroplasty at five‐year follow‐up

“…This may be attributable to better preservation of the periarticular soft tissue envelope in RO TKA enabling patients with higher functional demands to return to their pre‐disease level of activity with less “awareness” of the affected joint [7, 12, 22]. Similar trends of improved outcomes using robotic surgery compared with conventional manual surgery have also been shown in studies reporting on other robotic platforms for both TKA and unicompartmental knee arthroplasty [3, 9, 14]. Choi et al retrospectively reviewed outcomes in 120 patients and reported that the RO TKA improved patient satisfaction scores and patient‐reported outcome measures compared with CO TKA at two‐year follow‐up [11].…”

No Benefit of Robotic-Assisted over Computer-Assisted Surgery for Achieving Neutral Coronal Alignment in Total Knee Arthroplasty

“…Ali et al also found shorter LOS and earlier recovery in patients undergoing CI TKA on one knee and RAS TKA on the other using MAKO RAS system. 27…”

“…The exact alignment strategy was not described in that study, but since MAKO was used, one can assume aMA was used. Ali et al also found shorter LOS and earlier recovery in patients undergoing CI TKA on one knee and RAS TKA on the other using MAKO RAS-system 27 .…”

Arthrofibrosis in Robotic Total Knee Arthroplasty: An Investigation Into How Robotic Assistance May Contribute to a Tight Knee

“… 14 Recent literature suggests that robotic-assisted TKA (RATKA) leads to superior early postoperative outcomes when compared with patients operated on with conventional methods. 15 , 16 It is well known that arthrofibrosis is a potential complication after TKA. Arthrofibrosis is estimated to be responsible for 28% of 90-day hospital readmissions and 10% of revision surgeries within the first 5 years postoperatively.…”