Is sequential bilateral robotic total knee arthroplasty a safe procedure? A matched comparative pilot study

Batailler, Cécile; Anderson, Mike B.; Flécher, Xavier; Ollivier, Matthieu; Parratte, Sébastien

doi:10.1007/s00402-022-04455-9

Cited by 9 publications

(20 citation statements)

References 71 publications

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“…Second limitation is that the number of patients in C‐TKA group ( N = 34) was lower than those in RA‐TKA group ( N = 117), which could have led to type 2 errors in statistical analysis. It should be noted that the number of patients in C‐TKA group is still comparable or more than the previous similar studies [2, 28]. Another limitation of this study is that analysis between first and second operated knee in RA‐TKA and C‐TKA groups for functional outcomes and recovery time could not be performed due to lack of availability of this data.…”

Section: Discussionmentioning

confidence: 72%

Image‐free handheld robotic‐assisted technology improved the accuracy of implant positioning compared to conventional instrumentation in patients undergoing simultaneous bilateral total knee arthroplasty, without additional benefits in improvement of clinical outcomes

Albelooshi,

Hamie,

Bollars

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Purpose The purpose of this study was to compare the clinical and radiological outcomes in patients who underwent simultaneous bilateral total knee arthroplasty (SB-TKA) using either robotic-assisted TKA (RA-TKA) or conventional TKA (C-TKA). Methods Included were the patients who underwent SB-TKA between January 2018 and January 2020 and had a minimum follow-up of 2 years. Of 151 patients included, 117 patients were operated using an image-free handheld robotic sculpting system (RA-TKA group) and 34 patients operated using conventional instrumentation (C-TKA group). The key outcomes noted were multiple patient-reported outcomes (PROs), adverse events, and radiological outcomes. Two investigators independently measured the radiological outcomes on pre- and post-operative radiographs in coronal plane (medial proximal tibial angle [MPTA] and anatomic lateral distal femoral angle [aLDFA]) and sagittal plane (posterior tibial slope [PTS] and posterior condylar offset [PCO]). The chi-square test was used to examine categorical variables. Student’s t test was used to analyze the continuous variables. Results Patients in both groups were similar in baseline characteristics (gender, body mass index, incidence of comorbidities, and length of hospital stay) except that RA-TKA group patients younger (66.7 ± 8.9 vs 70.4 ± 10.5, P = 0.037) than C-TKA group. The operative time was longer in RA-TKA group as compared to C-TKA (189.3 ± 37.1 vs 175.0 ± 28.2, P = 0.040). The final PROs at each were similar between the two groups (P > 0.05). The values of PROs at final follow-up in RA-TKA compared to C-TKA were VAS pain (0.4 ± 0.9 vs 0.4 ± 0.5), KOOS-JR (89.3 ± 5.8 vs 87.1 ± 5.3), and physical (55.9 ± 2.8 vs 55.4 ± 3.2), mental (61.1 ± 4.4 vs 60.2 ± 4.7) component of VR-12 scores, and KSS satisfaction (37.5 ± 1.1 vs 37.1 ± 2.2) (all P > 0.50 or non-significant [n.s.]). While one patient in RA-TKA required revision of femoral component for peri-prosthetic fracture, none of the patient in conventional group were revised (0.85% vs 0%, P = n.s.). The proportion of patients with outliers in RA-TKA group was lower for aLDFA (2.6% vs 22.1%, P < 0.01) and PTS (0% vs 35%, P < 0.01). Conclusion This comparative study in patients undergoing SB-TKA found reduction of outliers in femoral and tibial implant positioning with RA-TKA as compared to C-TKA. There were no differences in both groups for pain, function, and satisfaction at a minimum of 2 years of follow-up. Level of evidence III Therapeutic Study.

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Section: Discussionmentioning

confidence: 72%

Image‐free handheld robotic‐assisted technology improved the accuracy of implant positioning compared to conventional instrumentation in patients undergoing simultaneous bilateral total knee arthroplasty, without additional benefits in improvement of clinical outcomes

Albelooshi,

Hamie,

Bollars

et al. 2023

Knee surg. sports traumatol. arthrosc.

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“…To our knowledge, there is only one other paper by Batailler et al (2022) that directly compares bilateral raTKA to bilateral convTKA. 9 Batailler et al found an increased operative time for the raTKA group but similar blood loss, length of stay, and postoperative pain between the two groups. In terms of clinical outcomes, a significantly improved Knee Society Score (KSS) at 6 months was reported for the raTKA group compared to the convTKA group, but no other clinically-relevant differences were found in range of motion, hip-knee angle, medial proximal tibial angle, or mechanical medial distal femoral angle.…”

Section: Discussionmentioning

confidence: 94%

“…Only one study examining the use of raTKA for simultaneous bilateral TKA procedures found similar outcomes between bilateral raTKAs and convTKAs including equivalent postoperative pain, length of stay, and blood loss. 9 Additionally, the raTKA group had an increased operative time but similar rates of early complications. 9 Unfortunately, this study was limited by a small sample size.…”

mentioning

confidence: 96%

“…9 Additionally, the raTKA group had an increased operative time but similar rates of early complications. 9 Unfortunately, this study was limited by a small sample size. 9 To address the gap assessing the use of bilateral raTKAs and its outcomes compared to bilateral conventional TKAs, the purpose of this study is to compare short-term results of simultaneous robotic-assisted bilateral TKAs to conventional bilateral TKAs.…”

mentioning

confidence: 96%

“…9 Unfortunately, this study was limited by a small sample size. 9 To address the gap assessing the use of bilateral raTKAs and its outcomes compared to bilateral conventional TKAs, the purpose of this study is to compare short-term results of simultaneous robotic-assisted bilateral TKAs to conventional bilateral TKAs. Our hypothesis was that robotic-assisted bilateral TKA (raTKA) will demonstrate similar outcomes to conventional bilateral TKAs (convTKA) but with significantly better self-reported and functional outcomes without increased complication rates.…”

mentioning

confidence: 98%

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Comparison of Short-term Results: Robotic-assisted vs. Conventional Bilateral Total Knee Arthroplasty

Kang,

Lee,

Mistretta

et al. 2024

Current Orthopaedic Practice

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Introduction: Robotic-assisted total knee arthroplasty is becoming widely accepted as a method to improve intra-operative measures and post-operative functional outcomes. While there is a large body of evidence supporting robotic-assisted unilateral total knee arthroplasty (TKA), few studies have examined the outcomes of this technology in simultaneous bilateral TKA procedures. Thus, the purpose of the study is to compare the clinical outcomes between patients undergoing simultaneous robot-assisted bilateral total knee arthroplasty (raTKA) versus conventional bilateral total knee arthroplasty (convTKA). Methods: We retrospectively reviewed 140 simultaneous bilateral TKA cases (61 conventional, 79 robot-assisted) performed by a single surgeon in a single institution from January 1, 2015 to December 11, 2020. The institution’s electronic medical records were reviewed for patient demographic information, operative data, and post-operative complications. Outcomes Based Electronic Research Database (OBERD) records were reviewed for patient-reported outcomes (Oxford Knee Score and SF-12 Version 1) preoperatively and postoperatively at 6 months, 1 year, and 2 years. Results: Both raTKA and convTKA groups exhibited clinically relevant improvements beyond the minimally clinically important difference (MCID) in SF-12 physical and Oxford Knee Scores at 6 months, 1 year, and 2 years post-surgery. There were no statistically significant differences found between the two groups in terms of postoperative SF-12 scores, Oxford Knee Scores, complications, or revision rates. The raTKA group had a longer length of stay (2.6 versus 2.2 days, P=0.001) and a significantly different discharge disposition with more patients entering acute rehab compared to the convTKA group (20 versus 7 patients respectively, P=0.031). Conclusion: Robotic-assisted total knee arthroplasty has a non-inferior impact on short-term patient outcomes compared to conventional methods in patients undergoing simultaneous bilateral total knee arthroplasty. Level of evidence: III

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Individualized alignment and ligament balancing technique with the ROSA® robotic system for total knee arthroplasty

Rossi

Benazzo

2023

International Orthopaedics (SICOT)

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Is sequential bilateral robotic total knee arthroplasty a safe procedure? A matched comparative pilot study

Cited by 9 publications

References 71 publications

Image‐free handheld robotic‐assisted technology improved the accuracy of implant positioning compared to conventional instrumentation in patients undergoing simultaneous bilateral total knee arthroplasty, without additional benefits in improvement of clinical outcomes

Image‐free handheld robotic‐assisted technology improved the accuracy of implant positioning compared to conventional instrumentation in patients undergoing simultaneous bilateral total knee arthroplasty, without additional benefits in improvement of clinical outcomes

Comparison of Short-term Results: Robotic-assisted vs. Conventional Bilateral Total Knee Arthroplasty

Individualized alignment and ligament balancing technique with the ROSA® robotic system for total knee arthroplasty

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