Robotic technology in total knee arthroplasty: a systematic review

Kayani, Babar; Konan, Sujith; Ayuob, Atif; Onochie, Elliot; Al-Jabri, Talal; Haddad, Fares S.

doi:10.1302/2058-5241.4.190022

Cited by 164 publications

(152 citation statements)

References 51 publications

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“…(e) The joint flexion and extension gap, joint stability, range of motion, and lower limb alignment can be evaluated by the robot system during the surgery. Meantime, surgeons can make real‐time modifications to bone resections, adjust the position of the prosthesis, and fine‐tuning soft tissue release to achieve the satisfied bone coverage, prosthesis position, knee kinematics, and lower limb alignment 1,30 …”

Section: Resultsmentioning

confidence: 99%

“…MAKO robot‐assisted system, a new semiautomatic robot‐assisted system, can use a three‐dimensional (3D) reconstructions of the knee joint based on computed tomographic (CT) scans to create a preoperative plan, monitor the surgical process in real‐time during surgery, and improve the accuracy of prosthesis 1 . However, in most countries and regions, the application of MAKO robot‐assisted arthroplasty is limited.…”

Section: Introductionmentioning

confidence: 99%

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A systematic review of MAKO‐assisted unicompartmental knee arthroplasty

Lin

Yan

et al. 2020

Robotics Computer Surgery

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Unicompartmental knee arthroplasty (UKA), which has many potential advantages compared with total knee arthroplasty, was widely used across the world in recent years. The introduction of the robot systems greatly makes up for the defects of the conventional UKA surgery such as higher complication rates and revision rates. MAKO system, a new image-guided robot system relies on a preoperative computed tomography scan to assist in preoperative mapping and planning, offers an opportunity to improve the outcome of UKA surgeries. In order to have a more comprehensive and in-depth understanding of MAKO-assisted UKA, the studies on MAKO-assisted UKA were summarized. MAKO-assisted UKA is better than conventional UKA surgery on implant accuracy, soft tissue balance, patient function scores and satisfaction, complications rates, and learning curve in short-term outcome; however, the mid-term and long-term outcomes of MAKO-assisted UKA need to be further studied.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A systematic review of MAKO‐assisted unicompartmental knee arthroplasty

Lin

Yan

et al. 2020

Robotics Computer Surgery

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“…Regarding clinical outcomes, patients’ satisfaction was increased in RA-TKA group with better early clinical outcomes compared to CM-TKA and no significant differences of ROM were reported between the two groups, in line with what is reported in the current literature. 12 , 13 Previous studies suggested that postoperative ROM and implant stability are influenced from the posterior inclination of the tibial component. 12 , 30 In addition, insufficient knee ROM is usually caused by inappropriate component sizing, a tight extension or flexion gap, component malalignment or malrotation, a lack of rehabilitation and swelling of the periarticular soft tissue.…”

Section: Discussionmentioning

confidence: 99%

“… 11-13 However, trust on robotic-TKA is limited by increased costs and longer operative time, associated with a lack of long-term evidence comparing clinical and functional outcomes to conventional manual TKA. 13 The restoration of mechanical axis (0° within ± 3° of standard deviation [SD]) through tibial and femoral perpendicular cuts with respect to their mechanical axis is strongly associated with higher implant survivorship and clinical outcomes. 11 , 12 , 14 , 15 …”

Section: Introductionmentioning

confidence: 99%

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What are the benefits of robotic-assisted total knee arthroplasty over conventional manual total knee arthroplasty? A systematic review of comparative studies

Mancino¹,

Cacciola²,

Malahias³

et al. 2020

Orthop Rev (Pavia)

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Total knee arthroplasty (TKA) is a highly successful operation that improves patients’ quality of life and functionality. Yet, up to 20% of TKA patients remain unsatisfied with the functional outcomes. Robotic TKA has gained increased attention and popularity in order to improve patient satisfaction and implant survivorship by increasing accuracy and precision of component implantation. The current systematic review was run in order to compare implant survivorship, complication rates, clinical outcomes, and radiological outcomes between robotic-assisted TKA (RA) and conventional manual TKA (CM). Articles were referenced from the US National Library of Medicine (PubMed/MEDLINE), EMBASE, and the Cochrane Database of Systematic Reviews. Nine comparative studies with 1199 operated knees in 1159 patients were included, 614 underwent active or semiactive robotic-assisted TKA compared to 585 CM-TKA. Improvements in the RA group were reported for early functional outcomes, radiographic outliers (RA 16% vs CM 76%) and radiolucent lines (RA 0% vs CM 35%). No significant differences between the two groups were reported in overall survivorship (RA 98.3% vs CM 97.3%), complication rate (RA 2.4% vs CM 1.4%) and operative time (RA 88 min vs CM 79 min). Despite higher costs, roboticassisted TKA offers better short-term clinical outcomes when compared to conventional manual technique with reduction in radiographic outliers and reduced risks of iatrogenic soft tissues injuries (reduced blood loss and postoperative drainage). Further high-quality long-term studies of modern robotic systems are required in order to evaluate how the increased accuracy and reduced outliers affect the long-term survivorship of the implants and the clinical outcomes.

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Robotic Assisted TKA achieves adjusted mechanical alignment targets more consistently compared to manual TKA without improving outcomes

Rajgopal,

Sundararajan,

Aggarwal

et al. 2024

J. exp. orthop.

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IntroductionRobotic total knee arthroplasty (rTKA), with its purported advantages of more accurate alignment, greater functional outcomes and patient satisfaction, is gaining popularity in patients undergoing TKA. The purpose of our study was to compare these parameters along with gait pattern and kneeling ability in a cohort of patients who underwent simultaneous TKA with manual instrumentation (mTKA) and rTKA in contralateral knees at a 1‐year follow‐up.MethodsThis was a retrospective review of 135 consecutive patients who underwent simultaneous bilateral TKA using robotic assistance on one side and manual instrumentation on the contralateral side between January 2022 and June 2022. The target alignment in both cohorts was adjusted mechanical. Patients were followed up at 3, 6 and 12 months to assess and compare alignment, range of motion (ROM) and patient‐reported outcome measures (PROM) data. Gait parameters and kneeling ability were assessed at 1‐year follow‐up.ResultsWhile adjusted mechanical alignment was achieved in all rTKA patients, we recorded five outliers (≥3° with relation to 180° HKA axis) in the mTKA cohort (three varus and two valgus). There were no significant differences between both cohorts with regards to ROM, PROM scores, gait analysis parameters and kneeling ability at 1‐year follow‐up.ConclusionrTKA helps in achieving the adjusted mechanical alignment more consistently than mTKA. This, however, does not contribute to better functional outcomes and patient satisfaction at 1‐year follow‐up.Level of EvidenceLevel III.

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Robotic technology in total knee arthroplasty: a systematic review

Cited by 164 publications

References 51 publications

A systematic review of MAKO‐assisted unicompartmental knee arthroplasty

A systematic review of MAKO‐assisted unicompartmental knee arthroplasty

What are the benefits of robotic-assisted total knee arthroplasty over conventional manual total knee arthroplasty? A systematic review of comparative studies

Robotic Assisted TKA achieves adjusted mechanical alignment targets more consistently compared to manual TKA without improving outcomes

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