Similar survivorship at the 5-year follow-up comparing robotic-assisted and conventional lateral unicompartmental knee arthroplasty

Abstract

Purpose This retrospective study aims to analyse the survivorship and functional outcomes of two samples with similar preoperative clinical and demographic data of lateral unicompartmental knee arthroplasty (UKA) performed with robotic and conventional surgery at a minimum 5-year follow-up. Methods In this retrospective study, the clinical records of two cohorts for 95 lateral UKA implants were analysed. The first cohort consisted of 43 patients with cemented lateral UKA performed with the conventional procedure (Conventional group). The second cohort consisted of 52 patients who received robot-assisted cemented lateral UKA (Robotic group). Clinical evaluation of the two samples entailed evaluating the Knee Injury and Osteoarthritis Outcome Score divided into subscales (symptoms and stiffness, pain, function in daily living, function in sport and recreation and quality of life) for each patient. Revision was defined as the failure of the implant (periprosthetic joint infection, periprosthetic fracture or aseptic loosening), and survival was based on implant revision. Results The mean follow-up time was 90.3 ± 9.1 months for the Conventional Group and 95.4 ± 11.0 months for the Robotic Group (n.s.). Each patient was clinically evaluated on the day before surgery (T0), at a minimum 1-year follow-up (T1) and at a minimum 5-year follow-up (T2). In both groups, all clinical scores improved between T0 and T1 and between T0 and T2 (p < 0.05); for both groups, no differences were noted in any clinical scores between T1 and T2 (n.s.). No significant differences in any clinical score were found between the two groups at each follow-up (n.s.). Survival analysis reported no differences between the two groups at the final 1-year follow-up, with three failures (2 aseptic loosening and 1 periprosthetic fracture) in the Conventional group and two failures (1 patellofemoral osteoarthritis and 1 inexplicable pain) in the Robotic group (n.s.). Conclusions This study shows excellent clinical outcomes and revision rates in robotic arm-assisted and manual techniques for lateral UKA, with no clinical differences at medium- to long-term follow-up. Level of evidence Level III—comparative study.

Mapping knowledge landscapes and emerging trends of robotic-assisted knee arthroplasty: A bibliometric analysis

“…This discord has raised concerns about the routine application of robotic technology. [20,39,43,46,[51][52][53] For instance, Maritan, Guido et al [54] exhibited excellent clinical outcomes and revision rates in both robotic arm-assisted and manual techniques for lateral UKA, with no discernible clinical disparities in medium-to long-term follow-up results. Considering the longterm horizon, as the robotics industry strives to attain heightened productivity, precision, and cost reduction, [43] the crux lies in achieving enhanced clinical outcomes while preserving efficiency-a pivotal concern in the future trajectory of robotic-assisted knee arthroplasty.…”

Unicompartmental knee arthroplasty improves mental health in patients with single compartment knee osteoarthritis

“…Furthermore, worse mental health scores are associated with a sharp decline in physical function 1 year after TKA [12]. UKA results in excellent outcomes in pain and function at 5-year and greater follow-up [11,16,19,26]; however, most studies do not address the impact on mental health. Goh et al demonstrated improvements in mental health when chronic osteoarthritic knee pain was remedied in patients with single compartment OA, but mental health scores were only reported at 2 year followup [6].…”

Fixed-bearing is superior to mobile-bearing in lateral unicompartmental knee replacement: a retrospective matched-pairs analysis

“…In recent years, robotic‐assisted UKR has emerged and has shown improved implant positioning compared with the conventional technique [4] as well as good clinical outcome and survivorship [10, 15]. However, an advantage of robotic‐assisted lateral UKR over conventional technique in terms of survivorship and clinical outcome has not yet been demonstrated [23]. To what extent robotics can optimise intraoperative balancing to decrease bearing dislocations remains unclear and needs to be further investigated.…”