Robot-Assisted Total Knee Arthroplasty Does Not Improve Long-Term Clinical and Radiologic Outcomes

Jeon, Seong Gyu; Kim, Kang‐Il; Song, Sang Jun

doi:10.1016/j.arth.2019.04.007

Cited by 87 publications

(85 citation statements)

References 29 publications

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“…Four TKA studies 24,25,27,32 5). No significant identifiers for heterogeneity were found across the studies, with no publication bias detected.…”

Section: Component Angle Outliersmentioning

confidence: 85%

“…Five UKA studies 19,29,[33][34][35] and six TKA studies [23][24][25]27,31,32 involving 4). Between-study heterogeneity was moderate across the UKA studies but was homogeneous across the TKA studies, with no significant moderators identified for heterogeneity.…”

Section: Coronal Tibial Component Angle Deviationmentioning

confidence: 94%

“…A total of five UKA studies [18][19][20][21][22] and six TKA studies [23][24][25][26][27][28] involving 321 and 585 knees respectively examined total operating time as an outcome. Meta-analysis showed that robot-assisted surgery significantly prolonged surgical time, for both UKA (weighted mean difference [WMD] ¼ 17.10 minutes, 95% CI: 13.24-20.97, p < 0.00001) and TKA (WMD ¼ 24.26 minutes, 95% CI: 8.70-39.82, p ¼ 0.002; ►Fig.…”

Section: Operation Timementioning

confidence: 99%

“…6). At long-term follow-up (>10 years), twoTKA studies 27,28 involving 553 knees analyzed Knee Society Function Score (KSFS) as an outcome, which showed no significant differences between the two modalities (WMD ¼ À1.79, 95% CI: À5.04 to 1.46, p ¼ 0.28; ►Fig. 6).…”

Section: Total Knee Arthroplastymentioning

confidence: 99%

“…Seven independent TKA studies [23][24][25]27,28,31,38 and three UKA studies 22,37,39 (involving 1,103 and 320 knees respectively) provided data for range of motion (ROM Fig. 3; available online only).…”

Section: Range Of Motionmentioning

confidence: 99%

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Robot-Assisted versus Conventional Total and Unicompartmental Knee Arthroplasty: A Meta-analysis of Radiological and Functional Outcomes

et al. 2020

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The study aims to provide an up-to-date systematic review and meta-analysis comparing radiological and functional outcomes of total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) using either robotic assistance or conventional methods from the latest assemblage of evidence. This study was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and MOOSE (Meta-analysis of Observational Studies in Epidemiology) guidelines. All studies in PubMed, EMBASE, Medline, and Cochrane that reported radiological and functional outcomes after TKA or UKA with either robotic or conventional methods were included in the review. Selected endpoints for random effects, pairwise meta-analysis included operative details, radiological outcomes (mechanical axis, component angle deviation, and outliers), and functional outcomes (American Knee Society Score, Knee Society Function Score, revision and complication rate, range of motion (ROM), Hospital for Special Surgery score, and Western Ontario and McMaster Universities Osteoarthritis Index). A total of 23 studies comprising 2,765 knees were included from the initial search. Robot-assisted TKA and UKA were associated with significantly better component angle alignment accuracy (low-to-high quality evidence) at the cost of significantly greater operation time. Robot-assisted UKA was found to have significantly better short-term functional outcomes compared with conventional UKA (moderate-to-high quality evidence). Robot-assisted TKA, however, did not exhibit significantly better short- and midterm subjective knee outcome scores compared with its conventional counterpart (high-quality evidence). Robot-assisted TKA and UKA were associated with nonstatistically significant improved ROM and lesser rates of revision. Robot-assisted total and unicompartmental knee arthroplasty leads to better radiological outcomes, with no significant differences in mid- and long-term functional outcomes compared with conventional methods for the former. Larger prospective studies with mid- and long-term outcomes are required to further substantiate findings from the present study.

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“…Four TKA studies 24,25,27,32 5). No significant identifiers for heterogeneity were found across the studies, with no publication bias detected.…”

Section: Component Angle Outliersmentioning

confidence: 85%

Section: Coronal Tibial Component Angle Deviationmentioning

confidence: 94%

Section: Operation Timementioning

confidence: 99%

Section: Total Knee Arthroplastymentioning

confidence: 99%

Section: Range Of Motionmentioning

confidence: 99%

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Robot-Assisted versus Conventional Total and Unicompartmental Knee Arthroplasty: A Meta-analysis of Radiological and Functional Outcomes

et al. 2020

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A new robotically assisted system for total knee arthroplasty: A sheep model study

Chen

Zhang

et al. 2021

Robotics Computer Surgery

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Background We investigated the accuracy and safety of a new HURWA robotic‐assisted total knee arthroplasty (TKA) system in a sheep model. Methods Ten male small‐tailed Han sheep were used in this study. Sheep were imaged by computed tomography scan before and after bone resection and the cutting errors between actual bone preparation and preoperative planning of the femur and tibia in three dimensions were measured. Results The overall accuracies after surgery compared with that from preoperative surgical planning of the left and right femurs were 1.93 ± 1.02° and 1.93 ± 1.23°, respectively. Additionally, similarly high overall accuracies for the left and right tibia of 1.26 ± 1.04 and 1.68 ± 0.92°, respectively, were obtained. The gap distances of the distal cut, anterior chamfer, anterior cut, posterior chamfer and posterior cut on the medial side were 0.47 ± 0.35 mm, 0.41 ± 0.37 mm, 0.12 ± 0.26 mm, 0.41 ± 0.44 mm and 0.12 ± 0.23 mm, respectively. No intraoperative complications, such as intraoperative fracture, massive bleeding or death, occurred. Conclusion This new HURWA robotic‐assisted TKA system is an accurate and safe tool for TKA surgery based on the sheep model.

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Advances in Navigation and Robot-Assisted Surgery

Corbett

Khan

2020

Orthopedics of the Upper and Lower Limb

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Robot-Assisted Total Knee Arthroplasty Does Not Improve Long-Term Clinical and Radiologic Outcomes

Cited by 87 publications

References 29 publications

Robot-Assisted versus Conventional Total and Unicompartmental Knee Arthroplasty: A Meta-analysis of Radiological and Functional Outcomes

Robot-Assisted versus Conventional Total and Unicompartmental Knee Arthroplasty: A Meta-analysis of Radiological and Functional Outcomes

A new robotically assisted system for total knee arthroplasty: A sheep model study

Advances in Navigation and Robot-Assisted Surgery

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