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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 7/2019

12.02.2019 | KNEE

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

verfasst von: Jason Wong, Taylor Murtaugh, Akshay Lakra, H. John Cooper, Roshan P. Shah, Jeffrey A. Geller

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 7/2019

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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.
Literatur
1.
Zurück zum Zitat Association AO (2017) Annual report: hip and knee replacement. Sydney. Australia, Australian Orthopaedic Association. 2018 Association AO (2017) Annual report: hip and knee replacement. Sydney. Australia, Australian Orthopaedic Association. 2018
2.
Zurück zum Zitat Amin AK, Patton JT, Cook RE, Gaston M, Brenkel IJ (2006) Unicompartmental or total knee arthroplasty?: results from a matched study. Clin Orthop Relat Res 451:101–106CrossRefPubMed Amin AK, Patton JT, Cook RE, Gaston M, Brenkel IJ (2006) Unicompartmental or total knee arthroplasty?: results from a matched study. Clin Orthop Relat Res 451:101–106CrossRefPubMed
4.
Zurück zum Zitat Bell SW, Anthony I, Jones B, MacLean A, Rowe P, Blyth M (2016) Improved accuracy of component positioning with robotic-assisted unicompartmental knee arthroplasty: data from a prospective, randomized controlled study. J Bone Joint Surg 98(8):627–635CrossRefPubMed Bell SW, Anthony I, Jones B, MacLean A, Rowe P, Blyth M (2016) Improved accuracy of component positioning with robotic-assisted unicompartmental knee arthroplasty: data from a prospective, randomized controlled study. J Bone Joint Surg 98(8):627–635CrossRefPubMed
5.
Zurück zum Zitat Berger RA, Meneghini RM, Jacobs JJ, Sheinkop MB, Della Valle CJ, Rosenberg AG, Galante JO (2005) Results of unicompartmental knee arthroplasty at a minimum of ten years of follow-up. J Bone Joint Surg 87(5):999–1006CrossRefPubMed Berger RA, Meneghini RM, Jacobs JJ, Sheinkop MB, Della Valle CJ, Rosenberg AG, Galante JO (2005) Results of unicompartmental knee arthroplasty at a minimum of ten years of follow-up. J Bone Joint Surg 87(5):999–1006CrossRefPubMed
6.
Zurück zum Zitat Bernardoni HS, Illgen R (2016) Manual versus robotic assisted unicompartmental knee arthroplasty: a comparison of validated clinical outcomes at 3 years, in 2016 American Association of Hip and Knee Surgeons Annual Meeting, Dallas, TX. 2016 Bernardoni HS, Illgen R (2016) Manual versus robotic assisted unicompartmental knee arthroplasty: a comparison of validated clinical outcomes at 3 years, in 2016 American Association of Hip and Knee Surgeons Annual Meeting, Dallas, TX. 2016
7.
Zurück zum Zitat Bruni D, Iacono F, Akkawi I, Gagliardi M, Zaffagnini S, Marcacci M (2013) Unicompartmental knee replacement: a historical overview. Joints 1(2):45PubMedPubMedCentral Bruni D, Iacono F, Akkawi I, Gagliardi M, Zaffagnini S, Marcacci M (2013) Unicompartmental knee replacement: a historical overview. Joints 1(2):45PubMedPubMedCentral
8.
Zurück zum Zitat Cobb J, Henckel J, Davies B et al (2006) Hands-on robotic unicompartmental knee replacement: a prospective, randomised controlled study of the acrobot system. J Bone Joint Surg Br 88(2):188–197CrossRefPubMed Cobb J, Henckel J, Davies B et al (2006) Hands-on robotic unicompartmental knee replacement: a prospective, randomised controlled study of the acrobot system. J Bone Joint Surg Br 88(2):188–197CrossRefPubMed
9.
Zurück zum Zitat Collier MB, Eickmann TH, Sukezaki F, McAuley JP, Engh GA (2006) Patient, implant, and alignment factors associated with revision of medial compartment unicondylar arthroplasty. J Arthroplasty 21(6):108–115CrossRefPubMed Collier MB, Eickmann TH, Sukezaki F, McAuley JP, Engh GA (2006) Patient, implant, and alignment factors associated with revision of medial compartment unicondylar arthroplasty. J Arthroplasty 21(6):108–115CrossRefPubMed
10.
Zurück zum Zitat Dunbar NJ, Roche MW, Park BH, Branch SH, Conditt MA, Banks SA (2012) Accuracy of dynamic tactile-guided unicompartmental knee arthroplasty. J Arthroplasty 27(5):803–808CrossRefPubMed Dunbar NJ, Roche MW, Park BH, Branch SH, Conditt MA, Banks SA (2012) Accuracy of dynamic tactile-guided unicompartmental knee arthroplasty. J Arthroplasty 27(5):803–808CrossRefPubMed
11.
Zurück zum Zitat Dyrhovden GS, Lygre SHL, Badawy M, Gøthesen Ø, Furnes O (2017) Have the causes of revision for total and unicompartmental knee arthroplasties changed during the past two decades? Clin Orthop Relat Res 475(7):1874–1886CrossRefPubMedPubMedCentral Dyrhovden GS, Lygre SHL, Badawy M, Gøthesen Ø, Furnes O (2017) Have the causes of revision for total and unicompartmental knee arthroplasties changed during the past two decades? Clin Orthop Relat Res 475(7):1874–1886CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Haaker R, Konermann W (2013) Computer and template assisted orthopedic surgery. Springer, Berlin Haaker R, Konermann W (2013) Computer and template assisted orthopedic surgery. Springer, Berlin
13.
Zurück zum Zitat Insall J, Aglietti P (1980) A five to seven-year follow-up of unicondylar arthroplasty. J Bone Joint Surg Am 62(8):1329–1337CrossRefPubMed Insall J, Aglietti P (1980) A five to seven-year follow-up of unicondylar arthroplasty. J Bone Joint Surg Am 62(8):1329–1337CrossRefPubMed
15.
Zurück zum Zitat Kini SG, Sathappan SS (2013) Robot-assisted unicondylar knee arthroplasty: a critical review. Orthopedics 1(1):4 Kini SG, Sathappan SS (2013) Robot-assisted unicondylar knee arthroplasty: a critical review. Orthopedics 1(1):4
16.
Zurück zum Zitat Kozinn SC, Scott R (1989) Unicondylar knee arthroplasty. J Bone Joint Surg Am 71(1):145–150CrossRefPubMed Kozinn SC, Scott R (1989) Unicondylar knee arthroplasty. J Bone Joint Surg Am 71(1):145–150CrossRefPubMed
17.
Zurück zum Zitat Laurencin CT, Zelicof SB, Scott RD, Ewald FC (1991) Unicompartmental versus total knee arthroplasty in the same patient. A comparative study. Clin Orthop Relat Res 273:151–156 Laurencin CT, Zelicof SB, Scott RD, Ewald FC (1991) Unicompartmental versus total knee arthroplasty in the same patient. A comparative study. Clin Orthop Relat Res 273:151–156
18.
Zurück zum Zitat Liabaud B, Patrick DA, Geller JA (2013) Higher body mass index leads to longer operative time in total knee arthroplasty. J Arthroplasty 28(4):563–565CrossRefPubMed Liabaud B, Patrick DA, Geller JA (2013) Higher body mass index leads to longer operative time in total knee arthroplasty. J Arthroplasty 28(4):563–565CrossRefPubMed
19.
Zurück zum Zitat Liddle AD, Pandit H, Judge A, Murray DW (2015) Patient-reported outcomes after total and unicompartmental knee arthroplasty: a study of 14,076 matched patients from the National Joint Registry for England and Wales. Bone Joint J 97(6):793–801CrossRefPubMed Liddle AD, Pandit H, Judge A, Murray DW (2015) Patient-reported outcomes after total and unicompartmental knee arthroplasty: a study of 14,076 matched patients from the National Joint Registry for England and Wales. Bone Joint J 97(6):793–801CrossRefPubMed
20.
Zurück zum Zitat Liow MHL, Goh GSH, Wong MK, Chin PL, Tay DKJ, Yeo SJ (2017) Robotic-assisted total knee arthroplasty may lead to improvement in quality-of-life measures: a 2-year follow-up of a prospective randomized trial. Knee Surg Sports Traumatol Arthrosc 25(9):2942–2951CrossRefPubMed Liow MHL, Goh GSH, Wong MK, Chin PL, Tay DKJ, Yeo SJ (2017) Robotic-assisted total knee arthroplasty may lead to improvement in quality-of-life measures: a 2-year follow-up of a prospective randomized trial. Knee Surg Sports Traumatol Arthrosc 25(9):2942–2951CrossRefPubMed
21.
Zurück zum Zitat Lombardi AV, Berend KR, Walter CA, Aziz-Jacobo J, Cheney NA (2009) Is recovery faster for mobile-bearing unicompartmental than total knee arthroplasty? Clin Orthop Relat Res 467(6):1450–1457CrossRefPubMedPubMedCentral Lombardi AV, Berend KR, Walter CA, Aziz-Jacobo J, Cheney NA (2009) Is recovery faster for mobile-bearing unicompartmental than total knee arthroplasty? Clin Orthop Relat Res 467(6):1450–1457CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Lonner JH, John TK, Conditt MA (2010) Robotic arm-assisted UKA improves tibial component alignment: a pilot study. Clin Orthop Relat Res 468(1):141CrossRefPubMed Lonner JH, John TK, Conditt MA (2010) Robotic arm-assisted UKA improves tibial component alignment: a pilot study. Clin Orthop Relat Res 468(1):141CrossRefPubMed
23.
Zurück zum Zitat Newman JH, Ackroyd CE, Shah NA (1998) Unicompartmental or total knee replacement? Five-year results of a prospective, randomised trial of 102 osteoarthritic knees with unicompartmental arthritis. J Bone Joint Surg Br 80(5):862–865CrossRefPubMed Newman JH, Ackroyd CE, Shah NA (1998) Unicompartmental or total knee replacement? Five-year results of a prospective, randomised trial of 102 osteoarthritic knees with unicompartmental arthritis. J Bone Joint Surg Br 80(5):862–865CrossRefPubMed
24.
Zurück zum Zitat Newman J, Pydisetty RV, Ackroyd C (2009) Unicompartmental or total knee replacement: the 15-year results of a prospective randomised controlled trial. J Bone Joint Surg Br 91(1):52–57CrossRefPubMed Newman J, Pydisetty RV, Ackroyd C (2009) Unicompartmental or total knee replacement: the 15-year results of a prospective randomised controlled trial. J Bone Joint Surg Br 91(1):52–57CrossRefPubMed
25.
Zurück zum Zitat Noticewala MS, Geller JA, Lee JH, Macaulay W (2012) Unicompartmental knee arthroplasty relieves pain and improves function more than total knee arthroplasty. J Arthroplasty 27(8):99–105CrossRefPubMed Noticewala MS, Geller JA, Lee JH, Macaulay W (2012) Unicompartmental knee arthroplasty relieves pain and improves function more than total knee arthroplasty. J Arthroplasty 27(8):99–105CrossRefPubMed
26.
Zurück zum Zitat Novak EJ, Silverstein MD, Bozic KJ (2007) The cost-effectiveness of computer-assisted navigation in total knee arthroplasty. J Bone Joint Surg 89(11):2389–2397PubMed Novak EJ, Silverstein MD, Bozic KJ (2007) The cost-effectiveness of computer-assisted navigation in total knee arthroplasty. J Bone Joint Surg 89(11):2389–2397PubMed
27.
Zurück zum Zitat Park SE, Lee CT (2007) Comparison of robotic-assisted and conventional manual implantation of a primary total knee arthroplasty. J Arthroplasty 22(7):1054–1059CrossRefPubMed Park SE, Lee CT (2007) Comparison of robotic-assisted and conventional manual implantation of a primary total knee arthroplasty. J Arthroplasty 22(7):1054–1059CrossRefPubMed
28.
Zurück zum Zitat Pearle AD, O’Loughlin PF, Kendoff DO (2010) Robot-assisted unicompartmental knee arthroplasty. J Arthroplasty 25(2):230–237CrossRefPubMed Pearle AD, O’Loughlin PF, Kendoff DO (2010) Robot-assisted unicompartmental knee arthroplasty. J Arthroplasty 25(2):230–237CrossRefPubMed
29.
Zurück zum Zitat Redmond JM, Gupta A, Hammarstedt JE, Petrakos AE, Finch NA, Domb BG (2015) The learning curve associated with robotic-assisted total hip arthroplasty. J Arthroplasty 30(1):50–54CrossRefPubMed Redmond JM, Gupta A, Hammarstedt JE, Petrakos AE, Finch NA, Domb BG (2015) The learning curve associated with robotic-assisted total hip arthroplasty. J Arthroplasty 30(1):50–54CrossRefPubMed
30.
Zurück zum Zitat Riddle DL, Jiranek WA, McGlynn FJ (2008) Yearly incidence of unicompartmental knee arthroplasty in the United States. J Arthroplasty 23(3):408–412CrossRefPubMed Riddle DL, Jiranek WA, McGlynn FJ (2008) Yearly incidence of unicompartmental knee arthroplasty in the United States. J Arthroplasty 23(3):408–412CrossRefPubMed
31.
Zurück zum Zitat Scott RD, Santore RF (1981) Unicondylar unicompartmental replacement for osteoarthritis of the knee. J Bone Joint Surg 63(4):536–544CrossRefPubMed Scott RD, Santore RF (1981) Unicondylar unicompartmental replacement for osteoarthritis of the knee. J Bone Joint Surg 63(4):536–544CrossRefPubMed
32.
Zurück zum Zitat Seon JK, Song EK, Park SJ, Yoon TR, Lee KB, Jung ST (2009) Comparison of minimally invasive unicompartmental knee arthroplasty with or without a navigation system. J Arthroplasty 24(3):351–357CrossRefPubMed Seon JK, Song EK, Park SJ, Yoon TR, Lee KB, Jung ST (2009) Comparison of minimally invasive unicompartmental knee arthroplasty with or without a navigation system. J Arthroplasty 24(3):351–357CrossRefPubMed
33.
Zurück zum Zitat Siebert W, Mai S, Kober R, Heeckt PF (2002) Technique and first clinical results of robot-assisted total knee replacement. Knee 9(3):173–180CrossRefPubMed Siebert W, Mai S, Kober R, Heeckt PF (2002) Technique and first clinical results of robot-assisted total knee replacement. Knee 9(3):173–180CrossRefPubMed
34.
Zurück zum Zitat Sinha RK (2009) Outcomes of robotic arm-assisted unicompartmental knee arthroplasty. J Orthop 38(2):20–22 Sinha RK (2009) Outcomes of robotic arm-assisted unicompartmental knee arthroplasty. J Orthop 38(2):20–22
35.
Zurück zum Zitat Sodhi N, Khlopas A, Piuzzi NS, Sultan AA, Marchand RC, Malkani AL, Mont MA (2018) The learning curve associated with robotic total knee arthroplasty. Knee 31(01):17–21CrossRef Sodhi N, Khlopas A, Piuzzi NS, Sultan AA, Marchand RC, Malkani AL, Mont MA (2018) The learning curve associated with robotic total knee arthroplasty. Knee 31(01):17–21CrossRef
36.
Zurück zum Zitat Van der List JP, Chawla H, Joskowicz L, Pearle AD (2016) Current state of computer navigation and robotics in unicompartmental and total knee arthroplasty: a systematic review with meta-analysis. Knee Surg Sports Traumatol Arthrosc 24(11):3482–3495CrossRefPubMed Van der List JP, Chawla H, Joskowicz L, Pearle AD (2016) Current state of computer navigation and robotics in unicompartmental and total knee arthroplasty: a systematic review with meta-analysis. Knee Surg Sports Traumatol Arthrosc 24(11):3482–3495CrossRefPubMed
37.
Zurück zum Zitat Walton NP, Jahromi I, Lewis PL, Dobson PJ, Angel KR, Campbell DG (2006) Patient-perceived outcomes and return to sport and work: TKA versus mini-incision unicompartmental knee arthroplasty. J Knee Surg 19(02):112–116CrossRefPubMed Walton NP, Jahromi I, Lewis PL, Dobson PJ, Angel KR, Campbell DG (2006) Patient-perceived outcomes and return to sport and work: TKA versus mini-incision unicompartmental knee arthroplasty. J Knee Surg 19(02):112–116CrossRefPubMed
38.
Zurück zum Zitat Weber P, Utzschneider S, Sadoghi P, Pietschmann MF, Ficklscherer A, Jansson V, Müller PE (2012) Navigation in minimally invasive unicompartmental knee arthroplasty has no advantage in comparison to a conventional minimally invasive implantation. Arch Orthop Trauma Surg 132(2):281–288CrossRefPubMed Weber P, Utzschneider S, Sadoghi P, Pietschmann MF, Ficklscherer A, Jansson V, Müller PE (2012) Navigation in minimally invasive unicompartmental knee arthroplasty has no advantage in comparison to a conventional minimally invasive implantation. Arch Orthop Trauma Surg 132(2):281–288CrossRefPubMed
Metadaten
Titel
Robotic-assisted unicompartmental knee replacement offers no early advantage over conventional unicompartmental knee replacement
verfasst von
Jason Wong
Taylor Murtaugh
Akshay Lakra
H. John Cooper
Roshan P. Shah
Jeffrey A. Geller
Publikationsdatum
12.02.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 7/2019
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-019-05386-6

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