Robotic-arm assisted total knee arthroplasty is associated with improved early functional recovery and reduced time to hospital discharge compared with conventional jig-based total knee arthroplasty

Abstract

AimsThe objective of this study was to compare early postoperative functional outcomes and time to hospital discharge between conventional jig-based total knee arthroplasty (TKA) and robotic-arm assisted TKA. Patients and MethodsThis prospective cohort study included 40 consecutive patients undergoing conventional jig-based TKA followed by 40 consecutive patients receiving robotic-arm assisted TKA. All surgical procedures were performed by a single surgeon using the medial parapatellar approach with identical implant designs and standardized postoperative inpatient rehabilitation. Inpatient functional outcomes and time to hospital discharge were collected in all study patients. ResultsThere were no systematic differences in baseline characteristics between the conventional jig-based TKA and robotic-arm assisted TKA treatment groups with respect to age (p = 0. Total knee arthroplasty (TKA) is an established and highly effective procedure that is performed in over 90 000 patients per year within the United Kingdom.1 The demand for TKA has grown rapidly over the last two decades during which time the overall costs have risen.2 To control this expenditure optimization of postoperative recovery and reducing length of hospital stay, whilst preserving the quality of care, is required. Developments in minimally invasive surgery, pain management, anaesthesia, deep vein thrombosis prophylaxis, antibiotic prophylaxis, implant design and manufacturing and enhanced rehabilitation techniques, have all ultimately focussed on optimizing postoperative recovery and duration of inpatient stay following TKA.2,3 Robotic-arm assisted technology has been used to enhance inpatient recovery and expedite discharge in gastrointestinal, urological, gynaecological surgery, and over the last decade in arthroplasty surgery.

The Impact of Surgeon Volume and Training Status on Implant Alignment in Total Knee Arthroplasty

“…While custom cutting guides offer theoretical advantages, the majority of mid-to-long-term studies assessing their efficacy have demonstrated nonsuperiority [20][21][22][23][24][25][26] . Although the true value and cost-effectiveness of robotic technology have been debated, the use of robotic-arm assistance has demonstrated superiority to patient-specific instrumentation 27 and has shown the ability to improve TKA alignment in multiple studies 19,[28][29][30][31][32] . The findings of the current study, especially if alignment outlier status is linked to increases in implant failure in follow-up studies, may justify the increased use of these technologies in the future.…”

“…As a result of the link between implant alignment outliers and early implant failure, efforts have been made to optimize alignment with the use of robotic navigation and patient-specific instrumentation [19][20][21][22][23][24][25][26][27][28][29][30][31][32] . However, little work has been conducted to identify the primary surgeon-specific factors that drive these outliers in order to understand the optimal patient populations in which to utilize this expensive technology.…”

Robotic Arm Assisted Total Knee Arthroplasty: Addressing 1-12 Degrees Valgus Knees

“…As valgus knees can require a greater amount of planning and precision, RA technology may be an option for surgeons to plan the case and make intraoperative component adjustments prior to bone cuts [5]. In literature, RA technology has been shown to reduce in post-operative pain and opioid usage which provides benefits to the patient and the hospital system [6]. This study required no intentional soft tissue releases, indicating RA TKA may reduce post-operative pain.…”

A 90-Day Episode-of-Care Cost Analysis of Robotic-Arm Assisted Total Knee Arthroplasty

“…These lower rTKA patient costs are likely attributable to the significantly lower index costs, increased likelihood of being discharged to home, shorter LOS, and decreased readmission rates, when compared to mTKA patient costs. Additional contributing factors may include a number of RAA-associated clinical, radiographic, and patient outcome advantages [4][5][6][7][8][9][10] . Future studies should build on these findings, by performing hospital and surgeon-specific cost analyses.…”