Short-Term Benefits of Robotic Assisted Total Knee Arthroplasty Over Computer Navigated Total Knee Arthroplasty Are Not Sustained With No Difference in Postoperative Patient-Reported Outcome Measures

Overview

Journal Arthroplast Today

Publisher Elsevier

Date 2022 May 5

PMID 35510065

Authors

Gavin Clark

Richard Steer

Bethany Tippett

David Wood

Affiliations

Soon will be listed here.

Abstract

Background: The purpose of this study was to compare early clinical and patient-reported outcomes between robotic assisted (RA) and computer navigation (CN) total knee arthroplasty (TKA).

Methods: One hundred and fifty patients were enrolled in this prospective, single-surgeon, cohort study, with 75 patients each receiving CN-TKA or RA-TKA in a consecutive series. There were no differences in patient age ( = .34) or body mass index ( = .09), but a higher proportion of males underwent RA-TKA ( = .03). We recorded hospital knee pain, analgesic usage, length of hospital stay, range of motion, and patient-reported outcome measures postoperatively for both patient cohorts.

Results: Hospital length of stay was shorter for the RA-TKA patients ( < .001). RA-TKA patients showed improved range of motion ( < .001) and decreased pain scores ( = .006) on day 1. Subsequent days showed no significant differences. Narcotic usage was lower for the RA-TKA group on day 2 postoperatively ( = .03) and onwards. Total morphine equivalent dose was also significantly lower for the RA-TKA than for the CN-TKA group ( < .001). There was no difference in Forgotten Joint Score ( = .24) or Oxford Knee Score ( = .51) between groups at 2 years postoperatively.

Conclusion: The use of RA-TKA demonstrated reduced postoperative analgesia usage and length of stay. There were no differences seen between CN-TKA and RA-TKA with respect to clinical outcomes at 2 years after surgery.

Citing Articles

Comparison between robotic-assisted and navigation-assisted total knee arthroplasty shows comparable outcomes: A systematic review and meta-analysis.

Melinte M, Simionescu L, Tabacar M, Blanaru V, Melinte R J Orthop. 2025; 68:96-104.

PMID: 40041811 PMC: 11875737. DOI: 10.1016/j.jor.2025.01.039.

Minimized Soft Tissue Release in Robotic-Assisted Total Knee Arthroplasty: A Retrospective Review of 100 Cases.

Londhe Sr S, Bajwa S, Rudraraju R, Shah R, Patel K, Velankar S Cureus. 2024; 16(8):e68062.

PMID: 39347313 PMC: 11436321. DOI: 10.7759/cureus.68062.

Robotics in total knee replacement: Current use and future implications.

Alrayes M, Sukeik M World J Orthop. 2024; 15(6):489-494.

PMID: 38947269 PMC: 11212528. DOI: 10.5312/wjo.v15.i6.489.

Multicenter, prospective cohort study: immediate postoperative gains in active range of motion following robotic-assisted total knee replacement compared to a propensity-matched control using manual instrumentation.

Fary C, Cholewa J, Ren A, Abshagen S, Anderson M, Tripuraneni K Arthroplasty. 2023; 5(1):62.

PMID: 38044446 PMC: 10694935. DOI: 10.1186/s42836-023-00216-0.

Incidence of soft tissue releases in robotic assisted cementless TKA with mechanical alignment and flexion gap balancing.

Selvanathan N, Ayeni F, Sorial R Arthroplasty. 2023; 5(1):28.

PMID: 37280658 PMC: 10245504. DOI: 10.1186/s42836-023-00188-1.

References

de Steiger R, Liu Y, Graves S . Computer navigation for total knee arthroplasty reduces revision rate for patients less than sixty-five years of age. J Bone Joint Surg Am. 2015; 97(8):635-42. DOI: 10.2106/JBJS.M.01496. View

Pelkowski J, Wilke B, Crowe M, Sherman C, Ortiguera C, Ledford C . Robotic-Assisted versus Manual Total Knee Arthroplasty in a Crossover Cohort: What Did Patients Prefer?. Surg Technol Int. 2020; 37:336-340. View

Khlopas A, Chughtai M, Hampp E, Scholl L, Prieto M, Chang T . Robotic-Arm Assisted Total Knee Arthroplasty Demonstrated Soft Tissue Protection. Surg Technol Int. 2017; 30:441-446. View

Marchand R, Sodhi N, Khlopas A, Sultan A, Harwin S, Malkani A . Patient Satisfaction Outcomes after Robotic Arm-Assisted Total Knee Arthroplasty: A Short-Term Evaluation. J Knee Surg. 2017; 30(9):849-853. DOI: 10.1055/s-0037-1607450. View

Chen Q, Hsia H, Overman R, Bryan W, Pepin M, Mariano E . Impact of an Opioid Safety Initiative on Patients Undergoing Total Knee Arthroplasty: A Time Series Analysis. Anesthesiology. 2019; 131(2):369-380. DOI: 10.1097/ALN.0000000000002771. View

Nicoll D, Rowley D . Internal rotational error of the tibial component is a major cause of pain after total knee replacement. J Bone Joint Surg Br. 2010; 92(9):1238-44. DOI: 10.1302/0301-620X.92B9.23516. View

Bhimani S, Bhimani R, Smith A, Eccles C, Smith L, Malkani A . Robotic-assisted total knee arthroplasty demonstrates decreased postoperative pain and opioid usage compared to conventional total knee arthroplasty. Bone Jt Open. 2020; 1(2):8-12. PMC: 7659658. DOI: 10.1302/2633-1462.12.BJO-2019-0004.R1. View

Kayani B, Konan S, Pietrzak J, Huq S, Tahmassebi J, Haddad F . The learning curve associated with robotic-arm assisted unicompartmental knee arthroplasty: a prospective cohort study. Bone Joint J. 2018; 100-B(8):1033-1042. DOI: 10.1302/0301-620X.100B8.BJJ-2018-0040.R1. View

Petursson G, Fenstad A, Gothesen O, Dyrhovden G, Hallan G, Rohrl S . Computer-Assisted Compared with Conventional Total Knee Replacement: A Multicenter Parallel-Group Randomized Controlled Trial. J Bone Joint Surg Am. 2018; 100(15):1265-1274. DOI: 10.2106/JBJS.17.01338. View

10.

Calliess T, Ettinger M, Savov P, Karkosch R, Windhagen H . Individualized alignment in total knee arthroplasty using image-based robotic assistance : Video article. Orthopade. 2018; 47(10):871-879. PMC: 6182501. DOI: 10.1007/s00132-018-3637-1. View

11.

Kayani B, Konan S, Tahmassebi J, Pietrzak J, Haddad F . 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: a prospective cohort study. Bone Joint J. 2018; 100-B(7):930-937. PMC: 6413767. DOI: 10.1302/0301-620X.100B7.BJJ-2017-1449.R1. View

12.

Amanatullah D, Di Cesare P, Meere P, Pereira G . Identification of the landmark registration safe zones during total knee arthroplasty using an imageless navigation system. J Arthroplasty. 2013; 28(6):938-42. DOI: 10.1016/j.arth.2012.12.013. View

13.

Kayani B, Konan S, Ayuob A, Onochie E, Al-Jabri T, Haddad F . Robotic technology in total knee arthroplasty: a systematic review. EFORT Open Rev. 2019; 4(10):611-617. PMC: 6836078. DOI: 10.1302/2058-5241.4.190022. View

14.

Marchand R, Sodhi N, Khlopas A, Sultan A, Higuera C, Stearns K . Coronal Correction for Severe Deformity Using Robotic-Assisted Total Knee Arthroplasty. J Knee Surg. 2017; 31(1):2-5. DOI: 10.1055/s-0037-1608840. View

15.

Jacofsky D, Allen M . Robotics in Arthroplasty: A Comprehensive Review. J Arthroplasty. 2016; 31(10):2353-63. DOI: 10.1016/j.arth.2016.05.026. View

16.

Robertsson O, Dunbar M, Pehrsson T, Knutson K, Lidgren L . Patient satisfaction after knee arthroplasty: a report on 27,372 knees operated on between 1981 and 1995 in Sweden. Acta Orthop Scand. 2000; 71(3):262-7. DOI: 10.1080/000164700317411852 . View

17.

Lim H, Song E, Seon J, Park K, Shin Y, Yang H . Causes of Aseptic Persistent Pain after Total Knee Arthroplasty. Clin Orthop Surg. 2017; 9(1):50-56. PMC: 5334027. DOI: 10.4055/cios.2017.9.1.50. View

18.

Anderson K, Buehler K, Markel D . Computer assisted navigation in total knee arthroplasty: comparison with conventional methods. J Arthroplasty. 2005; 20(7 Suppl 3):132-8. DOI: 10.1016/j.arth.2005.05.009. View

19.

Pang C, Chan W, Yen C, Cheng S, Woo S, Choi S . Comparison of total knee arthroplasty using computer-assisted navigation versus conventional guiding systems: a prospective study. J Orthop Surg (Hong Kong). 2009; 17(2):170-3. DOI: 10.1177/230949900901700209. View

20.

Bourne R, Chesworth B, Davis A, Mahomed N, Charron K . Patient satisfaction after total knee arthroplasty: who is satisfied and who is not?. Clin Orthop Relat Res. 2009; 468(1):57-63. PMC: 2795819. DOI: 10.1007/s11999-009-1119-9. View