Robotic-assisted vs conventional surgery in medial unicompartmental knee arthroplasty: a clinical and radiological study

Abstract

Background The use of unicompartmental knee arthroplasty (UKA) has increased and new technologies have been developed to improve patient survival and satisfaction, soft tissue balance, alignment, and component size. Robot-assisted systems offer an increase in surgical precision and accuracy. The purpose of this study is to evaluate the precision of component position using five radiological parameters in conventional and robotic-assisted medial UKA using the NAVIO system. Methods A cohort study was designed for patients who underwent medial UKA between April 2017 and March 2019 in a single center. Patients were allocated in the conventional (UKA-C) or robotic-assisted (UKA-R) group. The variables analyzed were age, gender, affected knee side, length of hospital stay, surgical time, and radiological measurements such as anatomical medial distal femoral angle (aMDFA), anatomical medial proximal tibial angle (aMPTA), tibial slope, the sagittal femoral angle, and the component size. A target was defined for each measurement, and a successful UKA was defined if at least four radiological measures were on target after surgery. Also, patients’ reported outcomes were evaluated using the Oxford Knee Score (OKS) and a numeric rating scale (NRS) for pain. Results Thirty-four patients were included, 18 of them underwent UKA-R. The success rate for UKA in the UKA-R group was 87%; meanwhile, in the UKA-C group this was 28%, this difference was significant and powered (Fisher’s exact test, p = 0.001; 1 − β = 0.95). Also, a 5-point difference in favor of the UKA-R group in the median OKS (p = 0.01), and a significantly lower median NRS for pain (p < 0.000) were found after surgery. Conclusions UKA-R achieved more precision in the radiological parameters’ measure in this study. Also, UKA-R has a trend towards a better OKS and a lower NRS for pain at short-term follow-up.

Comparison of Robotic and Conventional Unicompartmental Knee Arthroplasty Outcomes in Patients with Osteoarthritis: A Retrospective Cohort Study

“…This demonstrates the accuracy of bone and implant positioning in RUKA with the Mako system. Although the results are not identical to those of other studies, they are similar in that RUKA increased the accuracy of implant positioning [ 5 , 13 , 14 , 15 , 16 ]. A study by Bell et al [ 5 ] demonstrated that the implantation of components within 2° of the target position, when using the Mako system, was achieved in a relatively large proportion of patients.…”

Stiffness after unicompartmental knee arthroplasty: Risk factors and arthroscopic treatment

“…Then, several studies have shown a decrease in postoperative pain with the use of the robot [ 20 , 21 ]. This may also explain the decrease in the rate of stiffness in patients operated with robotic.…”

Revision Total Knee Arthroplasty Using Robotic Arm Technology

“…With improved accuracy in regard to restoration of joint line and balanced flexion and extension gaps, theoretically surgeons can decrease their rates of failure [ 21 ]. UKA has been showed to have better success rates at midterm follow-up when robotic-armed assistance was used [ [22] , [23] , [24] ]. In total hips, the computer-based software allows the surgeon to individualize the cup inclination/version, thereby decreasing dislocation rates [ 25 ].…”