Does Robotic Surgical Assistant (ROSA) Functionally Aligned TKA Lead to Higher Satisfaction Than Conventional Mechanically Aligned TKA: A Propensity-matched Pair Analysis

Overview

Journal J Orthop

Specialty Orthopedics

Date 2024 Nov 20

PMID 39564082

Authors

Edmund Jia Xi Zhang

William Yeo

Eric Xuan Liu

Jerry Yongqiang Chen

Hee Nee Pang

Seng Jin Yeo

Lincoln Ming Han Liow

Affiliations

Soon will be listed here.

Abstract

Objectives: Total knee arthroplasty (TKA) is the established treatment for severe knee osteoarthritis, with robotic-assisted TKA (rTKA) proposed to enhance surgical precision and potentially improve outcomes. This study investigates whether functionally-aligned rTKA using the ROSA Knee System results in superior functional outcomes and patient satisfaction compared to conventional mechanically aligned TKA (mTKA).

Methods: We conducted a retrospective, propensity-score matched cohort study including 154 patients (46 rTKA, 108 mTKA) who underwent primary TKA by a single surgeon from October 2020 to October 2023. Functionally-aligned (FA) rTKA was performed using the ROSA Knee System. Patients were assessed using the Short-Form 36 (SF36), Knee Society Knee Score (KSKS), Knee Society Function Score (KSFS), and Oxford Knee Score (OKS) preoperatively and at 6 months postoperatively. Immediate postoperative outcomes such as pain at rest and movement, ambulation distance, and range of motion were measured. Statistical analysis evaluated results at a 95 % confidence interval, with significance at < 0.05.

Results: No significant differences were observed in immediate postoperative pain at rest ( = 0.988), pain during movement ( = 0.634), ambulation distance ( = 0.243), and range of motion ( = 0.752) between the groups. At 6 months, there were no significant differences between rTKA and mTKA in achieving the minimal clinically important difference for SF36 ( = 0.996), KSKS ( = 0.150), KSFS ( = 0.091), and OKS ( = 0.949). No significant differences were noted for satisfaction levels ( = 0.315) and fulfilled expectations ( = 0.557) between both groups.

Conclusions: At 6 months postoperatively, FA rTKA demonstrated equivalent outcomes and satisfaction levels compared to mTKA. Future research should focus on examining longer-term follow-up outcomes, quantifying gap balance in MA mTKA to allow direct comparison with rTKA and studying alternative personalised alignment rTKA strategies to enhance patient outcomes.

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