One-Year Patient Outcomes for Robotic-Arm-Assisted versus Manual Total Knee Arthroplasty

Abstract

Although there are many studies on the alignment advantages when using the robotic arm–assisted (RAA) system for total knee arthroplasty (TKA), there have been questions regarding patient-reported outcomes. Therefore, the purpose of this study was to use this index to compare: (1) total, (2) physical function, and (3) pain scores for manual versus RAA patients. We compared 53 consecutive RAA to 53 consecutive manual TKAs. No differences in preoperative scores were found between the cohorts. Patients were administered a modified Western Ontario and McMaster Universities Osteoarthritis Index satisfaction survey preoperatively and at 1-year postoperatively. The results were broken down to: (1) total, (2) physical function, and (3) pain scores. Univariate analysis with independent samples t-tests was used to compare 1-year postoperative scores. Multivariate models with stepwise backward linear regression were utilized to evaluate the associations between scores and surgical technique, age, sex, as well as body mass index (BMI). Statistical analyses were performed with a p < 0.05 to determine significance. The RAA cohort had significantly improved mean total (6 ± 6 vs. 9 ± 8 points, p = 0.03) and physical function scores (4 ± 4 vs. 6 ± 5 points, p = 0.02) when compared with the manual cohort. The mean pain score for the RAA cohort (2 ± 3 points [range, 0–14 points]) was also lower than that for the manual cohort (3 ± 4 points [range, 0–11 points]) (p = 0.06). On backward linear regression analyses, RAA was found to be significantly associated with more improved total (β coefficient [β] −0.208, standard error [SE] 1.401, p < 0.05), function (β = 0.216, SE = 0.829, p < 0.05), and pain scores (β −0.181, SE = 0.623, p = 0.063). The RAA technique was found to have the strongest association with improved scores when compared with age, gender, and BMI. This study suggests that RAA patients may have short-term improvements at minimum 1-year postoperatively. However, longer term follow-up with greater sample sizes is needed to further validate these results.

How Does Robotic-Arm Assisted Technology Influence Total Knee Arthroplasty Implant Placement for Surgeons in Fellowship Training?

“…The group also evaluated outcomes at 1-year, and found the robotic-arm assisted cohort to have superior overall (p ¼ 0.03) and physical function score (p ¼ 0.02), as well as improvements in pain (p ¼ 0.06) when compared with the manual cohort. 10 In a large, multicenter prospective trial, patients who underwent RATKAs were all found to have substantially improved outcomes based on quality metrics including the Short Form-12 Questionnaire mental composite and physical composite scores, the Forgotten Joint Scores, and the Knee Society total and subscores. 7…”

“…RATKA for the operative management of knee osteoarthritis has consistently demonstrated excellent postoperative patient satisfaction. [7][8][9][10][11] RATKA platforms have the ability to integrate a preoperative computed tomography (CT) scan with robotic software, to develop a patient-specific operative plan. 12,13 This plan is then further enhanced in the operating room, with real-time haptic feedback helping guide bony cuts.…”

Adoption of Robotic-Arm-Assisted Total Knee Arthroplasty Is Associated with Decreased Use of Articular Constraint and Manipulation under Anesthesia Compared to a Manual Approach

“…Postoperative KSS were comparable between the two cohorts. A recent report 24 of improved total and physical function scores 1-year after RATKA compared with manual technique may indicate superior outcomes beyond the early recovery, but further studies are needed to confirm the observations of one center.…”

Minimum reporting criteria for robotic assisted total knee arthroplasty studies

“… 11 It is not always clearly stated in rTKA studies how the implant was aligned or how balance was achieved or defined. 1 , 3 The authors suggest there should be a minimum reporting criterion for future rTKA studies to clearly define these methods to allow the results to be interpreted in context. Currently all data from rTKA studies are being amalgamated on the assumption of a homogeneous group of patients and this may not be the case.…”