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Published on: September 7, 2022
Retrospective analysis of early functional and radiological outcomes between robotic, navigated and conventional
Jonathan Weng Kum Leong1, Bing Howe Lee1, Jikku Haniball1
1Department of Orthopedic Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, 308433, Singapore.
Background:
Achieving a neutral mechanical axis alignment (MAA) in Total Knee Arthroplasty (TKA) is associated with increased implant longevity and patient satisfaction, and robot-assisted (robotic) TKA is touted to improve implant placement accuracy and alignment. This study aims to analyse the functional outcomes and implant positioning between robotic, navigated, and conventional TKA in a single surgeon series.
Methods:
A total of 196 consecutive primary TKAs (49 robotic, 97 navigated, and 50 conventional) performed by a single surgeon were retrospectively reviewed. Post-operative Oxford Knee Score (OKS), Knee Society Scores (KSS), Visual Analogue Score (VAS), and EuroQol-5 Dimension (EQ-5 D) taken at 3 months and 1 year were analysed, while post-op radiographs taken at 1 year were reviewed. Statistical analysis was performed using SPSS software version 26 (IBM, Armonk, NY, USA).
Results:
Robotic TKA leads to better (1) MAA compared to navigated and conventional TKA (p = 0.001 and, p = 0.047 respectively), (2) tibiofemoral angle compared to navigated TKA (p = 0.043), (3) femoral coronal angle compared to both navigated and conventional TKA (p = 0.008 and, p = 0.037 respectively), (4) tibial coronal angle compared to conventional TKA (p = 0.037), and (5) femoral sagittal angle compared to conventional TKA (p = 0.042).Improvements in functional scores were noted for all 3 groups. Robotic TKA did not result in better OKS compared to other groups whereas navigated TKA resulted in better OKS than conventional TKA (p = 0.027 at 3 months, p = 0.010 at 1 year). Comparing all three groups, there was no statistically significant difference in KSS, VAS, and EQ-5D.
Conclusion:
While robotic surgery leads to more accurate implant positioning, it did not translate to improved functional outcomes compared to navigated or conventional TKA.
