Robot-assisted knee arthroplasty: first experience (a prospective randomized study)

Abstract

Introduction Primary total knee arthroplasty has long been proven effective in the treatment of stage 3–4 knee osteoarthritis. It is well known that this intervention not only improves the quality of life, but also helps to restore the function of the joint and eliminate axial deformities.Purpose To compare early results of total knee arthroplasty using robot-assisted technology with conventional manual technique.Materials and Methods 20 patients diagnosed with stage 3 osteoarthritis of the knee joint and varus deformity of the knee joint axis were included in a prospective randomized study. Patients were divided into 2 representative groups, 10 subjects underwent robot-assisted knee arthroplasty, and the conventional manual technique was used in the other 10 patients. For clinical assessment, functional scales KSS, WOMAC, Lysholm Score were used, postoperative radiographs were evaluated.Results According to clinical functional scales, 10 days after surgery, there was an improvement in performance in the patients of both groups (p < 0.05); the duration of the operation in the patients of both groups did not differ in general; intra-operative blood loss in the group with robot‑assisted arthroplasty was lower; and assessment of postoperative results by radiological imaging showed a better component positioning according to preoperative planning in the robotic group.Discussion When the operation is performed by experienced surgeons, one can expect the correct position of the components and the balance of the ligamentous apparatus in standard arthroplasty. However, the use of robot-assisted technology provides a secure intervention performance even at a hospital where a small number of such operations is performed.Conclusion Despite the high cost and the need for additional consumables, robot-assisted arthroplasty has a number of advantages over classical manual techniques. These advantages include: accurate restoration of the limb axis even in extra-articular deformities, correct position of the endoprosthesis components, reduction of intraoperative blood loss due to closed medullary canals, and safety for patients. However, the role of the surgeon in such operations remains paramount, as it is the surgeon who is responsible for planning the operation, performing it, and achieving soft tissue balance.