Technology assistance in primary total knee replacement: hype or hope?

Area of Science:

• Orthopedic surgery
• Medical technology innovation

Background:

• Total knee replacement (TKR) is effective in reducing pain and improving quality of life, with low revision rates.
• Technology assistance, including navigated, patient-specific, and robotic TKR, is increasingly explored to enhance outcomes.

Purpose of the Study:

• To critically evaluate the clinical relevance and evidence supporting technology-assisted total knee replacement (TKR).
• To assess the impact of technology assistance on TKR outcomes compared to conventional methods.

Main Methods:

• Review of meta-analyses of randomized controlled trials on technology-assisted TKR.
• Analysis of real-world evidence from implant registries for TKR outcomes.
• Consideration of data security implications with increasing technology use in TKR.

Main Results:

• Technology assistance in TKR generally improves accuracy in component positioning and alignment.
• No clinically significant differences in outcomes, quality of life, or complication rates (e.g., revisions) have been demonstrated compared to conventional TKR.
• Conventional TKR achieves acceptable outcomes, and current hopes for technology-assisted TKR are largely unsubstantiated by robust evidence.

Conclusions:

• While technology-assisted TKR offers potential benefits in precision, current evidence does not support superior clinical outcomes compared to traditional methods.
• The increasing use of technology in TKR necessitates a focus on data security for both patients and surgeons.
• The promotion of technology-assisted TKR may be outpacing the evidence of its clinical efficacy, suggesting a potential 'hype'.