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Navigated and Robot-Assisted Technology in Total Knee Arthroplasty: Do Outcome Differences Achieve Minimal Clinically
Armin Arshi1, Troy Sekimura2, Benjamin V Kelley2
1Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, Pennsylvania.
The Journal of Arthroplasty
|April 3, 2022
Summary
Computer-assisted and robotic-assisted total knee arthroplasty (TKA) show improved alignment but rarely achieve clinically significant patient-reported outcomes compared to conventional TKA. Further research is needed to set realistic expectations for these advanced TKA methods.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Clinical Outcomes Research
Background:
- Computer-assisted navigation (N-TKA) and robotic-assisted methods (RA-TKA) aim to enhance precision in total knee arthroplasty (TKA).
- The clinical significance of patient-reported outcome measure (PROM) differences between advanced TKA techniques and conventional TKA (C-TKA) remains unclear.
Purpose of the Study:
- To systematically review studies comparing N-TKA and RA-TKA with C-TKA.
- To assess the clinical significance of PROMs and radiographic outcomes in advanced TKA methods.
Main Methods:
- Systematic review of studies with a minimum 1-year follow-up.
- Comparison of perioperative PROMs and radiographic outcomes.
- Evaluation against minimal clinically important difference (MCID) values.
Main Results:
- Most studies reported improved radiographic alignment for N-TKA and RA-TKA versus C-TKA.
- A minority of studies showed statistically significant PROM improvements for N-TKA and RA-TKA.
- Few studies met the MCID threshold for clinical significance in PROMs; no difference in revision rates was found.
Conclusions:
- While advanced TKA techniques offer improved alignment, clinically significant PROM differences are infrequent.
- Future research should focus on clinical significance to manage patient and surgeon expectations for N-TKA and RA-TKA.
