Midterm Survivorship and Patient Satisfaction of Robotic-Arm-Assisted Medial Unicompartmental Knee Arthroplasty: A Multicenter Study

Kleeblad, Laura J.; Borus, Todd; Coon, Thomas M.; Dounchis, Jon; Nguyen, Joseph; Pearle, Andrew D.

doi:10.1016/j.arth.2018.01.036

Cited by 73 publications

(45 citation statements)

References 82 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…RA surgery with real time information on implant position and gap measurements with 1-mm increments allows the surgeon to accurately place the implants with greater precision (►Fig. 4). We feel that a combination of the several advantages of RA-TKA surgery including improved preoperative planning, more accurate bone cuts, precise gap balancing, decreased soft tissue trauma and the ability to achieve and confirm the target alignment has likely contributed to the increased patient satisfaction.…”

Section: Discussionmentioning

confidence: 99%

“…3 Conversely, in a 5-year follow-up study of 384 unicompartmental knee arthroplasty patients, 91% of the patients were either very satisfied or satisfied with their knee function. 4 There are several reasons for patient dissatisfaction following TKAs including component malalignment and instability. 5 Malalignment of greater than 3 degree has been identified in 32% of conventional TKAs and can lead to symptoms of pain and instability.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Improved Patient Satisfaction following Robotic-Assisted Total Knee Arthroplasty

et al. 2019

View full text Add to dashboard Cite

Approximately 20% of the patients are dissatisfied with their total knee arthroplasty (TKA). Computer technology has been introduced for TKA to provide real time intraoperative information on limb alignment and exact flexion/extension gap measurements. The purpose of this study was to determine if patient satisfaction could be improved with the use of robotic-assisted (RA) technology following primary TKA. A total of 120 consecutive patients undergoing RA-TKA with real time intraoperative alignment and gap balancing information were compared with a prospective cohort of 103 consecutive patients undergoing TKA with manual jig-based instruments during the same time period. There were no differences between groups with age, gender, baseline Knee Society Score (KSS) knee and function scores, follow-up, and ASA scores. TKAs were performed using same technique, implant design, anesthesia, and postoperative treatment protocols. Patient satisfaction survey using KSS and Likert scoring system were obtained at 1-year follow-up. Likert scoring system demonstrated 94% of the patients in the RA group were either very satisfied or satisfied versus 82% in the manual instruments TKA group (p = 0.005). RA-TKA group had better average scores of all five satisfaction questions although not significant. RA-TKA group had a better average overall satisfaction score of 7.1 versus 6.6 in the manual instrument group, p = 0.03. KSS function scores were significantly better at 6 weeks and 1 year postoperatively (p = 0.02, 0.005), and KSS knee scores were significantly better at 1 year postoperatively (p = 0.046). There are multiple reasons for patient dissatisfaction following primary TKA. Using intraoperative computer technology with RA surgery for patients undergoing a primary TKA, a significant improvement in patient satisfaction was demonstrated compared with TKA using conventional manual jig-based instruments. RA surgery provides several advantages in TKA including real time information in millimeters to help obtain balanced gaps, accurate bone cuts, reduced soft tissue injury, and achieve the target alignment which may lead to improved patient satisfaction.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Improved Patient Satisfaction following Robotic-Assisted Total Knee Arthroplasty

et al. 2019

View full text Add to dashboard Cite

show abstract

“…18,19 Advances in robotic-assisted surgery (r-UKA) facilitate a surgeon to accurately achieve the desired limb and component alignment, utilizing real-time feedback during the procedure. 14,15,18,20 More recent studies have demonstrated this with improved implant alignment, 15,18,21,22 implant survival, 23,24 soft-tissue balancing, 25 patient reported outcomes, 24 and decreased revision surgery with r-UKA. 23 The choice between t-UKA and r-UKA has economic implications, 14,26 and there is clinical data indicating that r-UKA may have better clinical outcomes compared with traditional UKA methods.…”

mentioning

confidence: 98%

“…14,15,18,20 More recent studies have demonstrated this with improved implant alignment, 15,18,21,22 implant survival, 23,24 soft-tissue balancing, 25 patient reported outcomes, 24 and decreased revision surgery with r-UKA. 23 The choice between t-UKA and r-UKA has economic implications, 14,26 and there is clinical data indicating that r-UKA may have better clinical outcomes compared with traditional UKA methods. [22][23][24] However, whether the incremental benefit from improved implant survival is worth the additional costs associated with the robotic system is still not well defined.…”

mentioning

confidence: 98%

Early Economic Analysis of Robotic-Assisted Unicondylar Knee Arthroplasty May Be Cost Effective in Patients with End-Stage Osteoarthritis

et al. 2020

View full text Add to dashboard Cite

Unicondylar knee arthroplasty (UKA), as an alternative to total knee arthroplasty (TKA), has been shown to be an effective option for patients with single-compartment end-stage knee osteoarthritis. Implant survival is contingent upon proper alignment, which has been improved with the advent of robotic-assisted surgery (r-UKA), but whether this outweighs the increased cost of the robotic-assist device has not been analyzed in the literature. The purpose of this study was to investigate the mid-term cost-effectiveness of r-UKA compared with UKA with traditional instrumentation (t-UKA) in the United States. A cost-effectiveness analysis using a four-state Markov model was performed using data from the 2018 National Joint Registry of England and Wales and a retrospective multicenter, cohort study on a cohort of 65-year-old patients having undergone r-UKA. The main outcome was cost per revision avoided and sensitivity analyses were conducted to evaluate the impact of using different model assumptions on the results. The Markov model illustrated that the benefit derived from r-UKA versus t-UKA was beneficial from a payer's perspective. The estimated incremental cost-effectiveness ratio (ICER) was $14,737 per revision avoided in a facility seeing 100 patients a year. Case volume was shown to be the primary variable affecting cost-effectiveness, with the value of r-UKA directly increasing with higher case volumes. Cost-effectiveness analyses demonstrated that the use of r-UKA is an effective alternative to t-UKA in patients with single-compartment knee osteoarthritis. While this study could benefit from longer follow-up clinical studies to illustrate the benefits of r-UKAs beyond the current 2 years time horizon, r-UKAs remained cost-effective, even after investigating several different assumptions.

show abstract

“…Although several reports have already illustrated the short-term outcomes of robotic-assisted UKA [10,12], there are few studies containing mid-term results [13,14]. Unfortunately, to our knowledge, no prospective randomized study comparing component position or clinical outcomes of the robotic-assisted UKA with conventional UKA at a mid-term follow-up is available.…”

Section: Introductionmentioning

confidence: 99%

Superior component position during robotic-assisted Oxford unicompartmental knee arthroplasty (UKA) compared with conventional technique: A 5-year follow-up study

Zhang

Cai

Zhang

et al. 2020

Preprint

View full text Add to dashboard Cite

BackgroundThe purpose of our present work was to compare robotic-assisted UKA and conventional UKA regarding the clinical and radiographic results at 5-year follow-up.MethodsForty-one medial UKAs were conducted with robotic assistance (group ROA) between January 2010 and January 2015, and these subjects were matched with 44 subjects undergoing medial UKAs using the same prosthesis, implanted by conventional technique (group CON). In a 5-year follow-up, subjects were clinically evaluated by using Knee Society functional (KSF), Knee Society clinical (KSC), and Knee Society pain (KSP) scores. Radiographic assessments with regards to coronal mechanical axis (CMA) and condylar twist angle (CTA) were compared between group ROA and group CON.ResultsIn the evaluation, the mechanical limb alignment was significantly increased after operation in each group. The implantation accuracy of the coronal mechanical axis was similar in both groups. As for the evaluation of femoral rotation, the internal rotation in group ROA was remarkably less than that in group CON. The difference was not significant in KSP, KSF, KSC scores between group ROA and group CON.ConclusionOur results showed that robotic assistance improves component position without gaining superior CMA or increasing clinical results versus conventional UKA at 5-year follow-up. To conclude, using robotic assistance in UKA is recommended as compared to conventional UKA. Long-term follow-up will be needed to draw conclusion about the overall outcomes of robotic assistance as compared with conventional technique.Trial registrationCurrent Controlled Trials ChiCTR2000033918. Registered 16 June 2020.

show abstract

Midterm Survivorship and Patient Satisfaction of Robotic-Arm-Assisted Medial Unicompartmental Knee Arthroplasty: A Multicenter Study

Cited by 73 publications

References 82 publications

Improved Patient Satisfaction following Robotic-Assisted Total Knee Arthroplasty

Improved Patient Satisfaction following Robotic-Assisted Total Knee Arthroplasty

Early Economic Analysis of Robotic-Assisted Unicondylar Knee Arthroplasty May Be Cost Effective in Patients with End-Stage Osteoarthritis

Superior component position during robotic-assisted Oxford unicompartmental knee arthroplasty (UKA) compared with conventional technique: A 5-year follow-up study

Contact Info

Product

Resources

About