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Robotic-assisted unicompartmental knee replacement offers no early advantage over conventional unicompartmental knee replacement

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Unicompartmental knee arthroplasty (UKA) is effective for treating degenerative joint disease in a single compartment. Robotic-arm-assisted arthroplasty (RAA) has gained popularity and has theoretical benefits of improved outcomes over conventional (CONV) UKA due to the technical precision of bone preparation. This study compares the short-term clinical outcomes, including survivorship and patient-reported functional outcomes, for a series of medial UKAs performed with RAA and CONV.

Methods

One hundred seventy-six consecutive fixed-bearing medial UKAs were retrospectively identified with a minimum follow-up of 2 years. One hundred and eighteen CONV and 58 RAA were performed. Pre- and post-operative SF12, WOMAC, and KSS Functional Questionnaires were available for all patients.

Results

At 2 years, both groups improved in all functional outcomes, with no significant difference between the RAA and CONV cohorts. However, the RAA cohort had a significantly longer operative time (p < 0.001) and a higher early revision rate than the CONV group (7 [12.0%] vs. 7 [6.8%]; p < 0.05).

Conclusions

These results demonstrate that at short-term follow-up of 2 years, RAA was not superior to CONV in terms of functional scores and instead was associated with greater operative time and cost and lower survivorship. Therefore, at this time usage of RAA in UKA is not recommended compared to conventional UKA. Longer term studies are necessary to draw conclusions about the overall outcomes of RAA compared to CONV.

Level of evidence

III.

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Acknowledgements

The authors would like to acknowledge the following people for their help with data analysis and manuscript editing: Katherine MacCallum, MD and David Patrick, MD.

Funding

No authors received outside funding for the support of this work.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Center for Hip and Knee Replacement (CHKR), NewYork-Presbyterian Hospital at Columbia University Medical Center, 622 W. 168th Street, PH 1155, New York, NY, 10032, USA

    Taylor Murtaugh, H. John Cooper, Roshan P. Shah & Jeffrey A. Geller

  2. Maimonides Medical Center Brooklyn, New York, USA

    Jason Wong

  3. Montefiore Medical Center Bronx, New York, USA

    Akshay Lakra

Authors
  1. Jason Wong
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  2. Taylor Murtaugh
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  3. Akshay Lakra
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  6. Jeffrey A. Geller
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Correspondence to Jeffrey A. Geller.

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Wong, J., Murtaugh, T., Lakra, A. et al. Robotic-assisted unicompartmental knee replacement offers no early advantage over conventional unicompartmental knee replacement. Knee Surg Sports Traumatol Arthrosc 27, 2303–2308 (2019). https://doi.org/10.1007/s00167-019-05386-6

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