Comparison of robotic‐assisted versus conventional unicompartmental knee arthroplasty for the treatment of single compartment knee osteoarthritis: A meta‐analysis

Zhang, Pei; Xu, Keteng; Zhang, Jiale; Chen, Pengtao; Fang, Yongchao; Wang, Jingcheng

doi:10.1002/rcs.2170

Cited by 7 publications

(13 citation statements)

References 41 publications

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“…1). In all ten meta‐analyses, conventional knee arthroplasty was considered the control group; three analysed outcomes of robot‐assisted UKA [12, 47, 48], six analysed outcomes of robot‐assisted TKA [1, 13, 20, 28, 32, 35], and one analysed outcomes of both robot‐assisted UKA and TKA [7].…”

Section: Resultsmentioning

confidence: 99%

“…One meta‐analysis [7] included 13 studies on UKA, one of which [31] did not report on robotic assistance, but instead compared patient‐specific to conventional instrumentation in terms of postoperative knee alignment and knee society score (KSS). One meta‐analysis was found to be of “good quality” [48], and three were found to be of ‘critically low quality’ due to weaknesses in more than two critical domains [7, 12, 47] (Table 2, Fig. 2).…”

Section: Resultsmentioning

confidence: 99%

“…The database searches returned 96 records, of which 19 were duplicates, 77 were excluded based on title and abstract screening, and 6 articles [4,5,14,[42][43][44] were excluded based on full text review. This left a total of ten meta-analyses, published between 2018 and 2020, eligible for data extraction [1,7,12,13,20,28,32,35,47,48] (Fig. 1).…”

Section: Literature Searchmentioning

confidence: 99%

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Robot-assisted knee arthroplasty improves component positioning and alignment, but results are inconclusive on whether it improves clinical scores or reduces complications and revisions: a systematic overview of meta-analyses

Kort¹,

Stirling

Pilot³

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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Purpose The purpose of this systematic overview was to identify, synthesise and critically appraise indings of meta-analyses on robot-assisted versus conventional unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA). The hypothesis was that robotic assistance would reduce complications and revision rates, yield better clinical scores, and improve component positioning and alignment. Methods Two researchers independently conducted a literature search using Embase ® , MEDLINE ® , Web of Science, Allied and Complementary Medicine™ and Cochrane Database of Systematic Reviews on 2 November 2020 for meta-analyses (Level I-IV) on robotic assistance in UKA and/or TKA. Outcomes were tabulated and reported as weighted mean diference (WMD), risk ratio (RR) or weighted odds ratio (WOR), and were considered statistically signiicant when p < 0.05. Results A total of ten meta-analyses were identiied; four on robot-assisted UKA (n, 1880 robot-assisted vs. 2352 conventional UKA; follow-up, 0 to 60 months), seven on robot-assisted TKA (n, 4567 robot-assisted vs. 5966 conventional TKA; follow-up, 0 to 132 months). Of the meta-analyses on UKA, one found that robotic assistance reduced complication rates (relative risk (RR), 0.62), one found that it improved clinical scores (weighted mean diference (WMD), 19.67), three found that it extended operation times (WMD, 15.7 to 17.1 min), and three found that it improved component positioning and alignment (WMD, − 1.30 to − 3.02 degrees). Of the meta-analyses on TKA, two found that robotic assistance improved clinical scores (WMD, 1.62-1.71), two found that that it extended surgery times (WMD, 21.5-24.26 min), and ive found that it improved component positioning and alignment (WMD, − 0.50 to − 10.07 degrees). None of the meta-analyses reported diferences in survivorship between robot-assisted versus conventional knee arthroplasty. Conclusion Robot-assisted knee arthroplasty enabled more accurate component positioning and placement within target zones, but extended operation time considerably. Although robotic assistance improved component positioning, its beneits regarding clinical scores, patient satisfaction and implant survivorship remains to be conirmed. Finally, this overview revealed that six of the ten meta-analyses were of 'critically low quality', calling for caution when interpreting results. Level of evidence IV.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Literature Searchmentioning

confidence: 99%

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Robot-assisted knee arthroplasty improves component positioning and alignment, but results are inconclusive on whether it improves clinical scores or reduces complications and revisions: a systematic overview of meta-analyses

Kort¹,

Stirling

Pilot³

et al. 2021

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

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“…The workspace of the robot is specifically adapted for unicompartmental knee arthroplasty considering inherent safety. The objective is to provide a versatile robotic tool which improves the accuracy of implant positioning and reduces the revision rate, as reported in literature [ 17 , 19 , 20 ], while optimizing its integration into the conventional surgical workflow.…”

Section: Introductionmentioning

confidence: 99%

MINARO HD: control and evaluation of a handheld, highly dynamic surgical robot

et al. 2021

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Purpose Current surgical robotic systems are either large serial arms, resulting in higher risks due to their high inertia and no inherent limitations of the working space, or they are bone-mounted, adding substantial additional task steps to the surgical workflow. The robot presented in this paper has a handy and lightweight design and can be easily held by the surgeon. No rigid fixation to the bone or a cart is necessary. A high-speed tracking camera together with a fast control system ensures the accurate positioning of a burring tool. Methods The capabilities of the robotic system to dynamically compensate for unintended motion, either of the robot itself or the patient, was evaluated. Therefore, the step response was analyzed as well as the capability to follow a moving target. Results The step response show that the robot can compensate for undesired motions up to 12 Hz in any direction. While following a moving target, a maximum positioning error of 0.5 mm can be obtained with a target motion of up to 18 mm/s. Conclusion The requirements regarding dynamic motion compensation, accuracy, and machining speed of unicompartmental knee arthroplasties, for which the robot was optimized, are achieved with the presented robotic system. In particular, the step response results show that the robot is able to compensate for human tremor.

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“…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%

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

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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.

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Comparison of robotic‐assisted versus conventional unicompartmental knee arthroplasty for the treatment of single compartment knee osteoarthritis: A meta‐analysis

Cited by 7 publications

References 41 publications

Robot-assisted knee arthroplasty improves component positioning and alignment, but results are inconclusive on whether it improves clinical scores or reduces complications and revisions: a systematic overview of meta-analyses

Robot-assisted knee arthroplasty improves component positioning and alignment, but results are inconclusive on whether it improves clinical scores or reduces complications and revisions: a systematic overview of meta-analyses

MINARO HD: control and evaluation of a handheld, highly dynamic surgical robot

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

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