Robotics in orthopaedic surgery: why, what and how?

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Abstract

[Indexed for MEDLINE] 17. J Arthroplasty. 2022 May;37(5):831-836. doi: 10.1016/j.arth.2022.01.023. Epub 2022 Jan 19. Midterm Survivorship of Robotic-Assisted Lateral Unicompartmental Knee Arthroplasty. Heckmann ND(1), Antonios JK(1), Chen XT(2), Kang HP(1), Chung BC(1), Piple AS(1), Christ AB(1), Gilbert PK(1). Author information: (1)Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA. (2)Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN. BACKGROUND: Lateral unicompartmental knee arthroplasty (UKA) is a popular alternative to total knee arthroplasty (TKA) for patients with isolated lateral compartment osteoarthritis. Few studies have investigated outcomes following robotic-assisted lateral UKA. The purpose of this study is to evaluate mid-term survivorship and patient-reported outcomes of robotic-assisted lateral UKA. METHODS: A retrospective case series was conducted on all robotic-assisted lateral UKAs performed by a single surgeon between 2013 and 2019. Patient demographics, surgical variables, and Kozinn and Scott criteria were collected. Implant survivorship was estimated using the Kaplan-Meier method with all-cause reoperation and conversion to TKA as endpoints. Participating patients were assessed for patient satisfaction and the Forgotten Joint Score-12. Correlations between patient demographics and patient outcome scores were investigated. RESULTS: In total, 120 lateral UKAs were identified, 84 of which met inclusion criteria, with a mean follow-up of 4.0 years (range 2.0-7.0). Five-year survivorship was 92.9% (95% confidence interval [CI] 84.5-96.7) with all-cause reoperation as the endpoint, and 100% (95% CI 95.0-100) with conversion to TKA as the endpoint. One patient was converted to TKA after the 5-year mark, resulting in a 6-year survival for conversion to TKA of 88.9% (95% CI 44.9-98.5). Average Forgotten Joint Score-12 score was 82.7/100, and patient satisfaction 4.7/5. Mean coronal plane correction was 2.5° ± 1.9° toward the mechanical axis. Neither final postoperative alignment nor failure to meet classic Kozinn and Scott criteria for UKA resulted in differences in patient-reported outcomes. CONCLUSION: The current study demonstrates high mid-term survivorship and excellent patient-reported outcomes with robotic-assisted lateral UKA. Robotic-assisted lateral UKA is a viable treatment option for isolated lateral compartment arthritis even in patients who do not meet classic indications. Copyright © 2022 Elsevier Inc. All rights reserved. DOI: 10.1016/j.arth.2022.01.023