Abstract
Introduction
Robotic-assisted total knee arthroplasty (TKA) was introduced to improve limb alignment, component positioning, and soft-tissue balance, yet the effect of adoption of this technology has not been established. This study was designed to evaluate whether robotic-assisted TKA leads to improved patient reported outcome measures (PROMs) and patient satisfaction as compared to conventional TKA at 3 and 12 months.
Methods
This IRB-approved single-surgeon retrospective cohort analysis of prospectively collected data compared 113 conventional TKA patients with 145 imageless robotic-assisted TKA patients (Navio™ Surgical System, Smith&Nephew®, Memphis TN). Basic demographic information, intraoperative and postoperative data, and PROMs (SF-P, SF-M, WOMAC pain, WOMAC stiffness, WOMAC Physical Function, KSS) were collected and recorded preoperatively, at 3 months, and at 12 months following surgery. Range of motion (ROM), blood loss, surgical duration, and complication rates between groups were also collected. Continuous measures such as mean difference in PROMs and ROM were compared using unpaired t-tests. Categorical measures such as the percentage of patients with complications were compared using chi-square analysis.
Results
There were no baseline demographic differences or preoperative PROMs between groups. Following TKA, there were no differences between groups with respect to ROM or any of the PROMs (SF-P, SF-M, WOMAC pain, WOMAC stiffness, WOMAC Physical Function, and KS scores) at 3- or 12-months. Difference between the group included larger EBL(242 vs 209 mL, p<.001) and longer surgical duration (119 vs 107minutes, p<.001) for robotic-assisted surgery. There were no differences between the two groups in total post operative complications however subgroup analysis demonstrated that the robotic assisted cohort had fewer periprosthetic joint infections (1 vs 3, p=.048) and total reoperations (1 vs 7, p=.0114).
Conclusions
Imageless robotic-assisted TKA resulted in similar function and satisfaction scores when compared to conventional TKA at 3 and 12 months. While EBL and surgical duration were greater with robotic-assisted TKA, this technique resulted in fewer reoperations and periprosthetic wound infections.
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