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Use of the VELYS Robotic-Assisted Solution in knee arthroplasty: A scoping review
Scott R Morrison1,2,3, Andrew J Hall1,2,3, Nick D Clement2,3,4
1Department of Orthopaedics Golden Jubilee University National Hospital Clydebank UK.
Purpose:
Robotic knee arthroplasty has been associated with improved knee-specific outcomes, but results are relatively immature. The VELYS Robotic-Assisted Solution is an imageless semi-active system used with the ATTUNE knee arthroplasty system. Recently, the UK National Institute for Health and Care Excellence called for a multidomain evaluation of six robotic-surgery platforms in orthopaedics, of which VELYS is one. This review aimed to (i) evaluate current evidence on VELYS in total knee arthroplasty, (ii) assess outcomes, complications, cost and versatility, (iii) appraise study quality and (iv) identify knowledge gaps.
Methods:
A scoping review using five-stage methodology following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines was undertaken. Articles were screened against pre-determined criteria, with data synthesized descriptively and thematically.
Results:
One hundred twenty-six studies were identified, with 22 included. Evidence level ranged from II to IV. Analysis highlighted improved implant positioning as seen with other robotic systems, as well as a non-inferior safety profile. However, despite studies appearing to highlight favourable early patient-reported outcomes and function as well as greater workflow efficiency, the overall quality of the published work was poor, giving little evidence to robustly support many of the conclusions drawn in these studies. Limitations of these studies included small sample sizes, a lack of information on patient characteristics and patient selection, retrospective design and a lack of long-term follow-up.
Conclusion:
The available literature regarding the VELYS Robotic-Assisted Solution is limited and of moderate-to-poor quality. Implant positioning was more accurate; however, other results, especially regarding improved patient outcomes, are not currently well-evidenced. Evidence was largely retrospective or early prospective, with no randomized controlled trials or long-term data. High-quality, randomized studies are required to evidence this technology.
Level Of Evidence:
N/A.
