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Robotic trials in arthroplasty surgery.

Chetan Khatri1,2, Andrew Metcalfe1,2, Peter Wall1,3

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|January 31, 2024
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Summary

Robotic-assisted surgery for total hip and knee arthroplasty (THA, TKA) is being explored to improve patient outcomes. The RACER trials are evaluating if robotic assistance offers better results and cost-effectiveness compared to traditional methods.

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Area of Science:

  • Orthopedic Surgery
  • Robotics in Medicine
  • Clinical Trials

Background:

  • Total hip and knee arthroplasty (THA, TKA) have variable outcomes, leading to patient dissatisfaction.
  • Robotic-assisted surgery is emerging as a potential solution to enhance surgical results.

Purpose of the Study:

  • To evaluate the clinical effectiveness and cost-effectiveness of robotic-assisted THA and TKA.
  • To compare Mako-assisted procedures against conventional surgical techniques.

Main Methods:

  • Multicentre, patient-blinded randomized controlled trials (RACER trials).
  • Inclusion of patients with primary osteoarthritis of the hip or knee.
  • Primary outcome: Forgotten Joint Score at 12 months; secondary outcomes: pain, component alignment, and long-term results.

Main Results:

  • The study is designed to assess the primary clinical outcome (Forgotten Joint Score) and cost-effectiveness.
  • Secondary outcomes will provide insights into early pain, component alignment, and medium- to long-term patient benefits.

Conclusions:

  • Robust evidence is required to determine the true benefit of robotic innovations in arthroplasty.
  • The study addresses challenges in trial design, including surgical workflows, blinding, and learning curves for robotic surgery.