Clinical and patient-reported outcomes of a novel robotic system in total knee arthroplasty

IF 2 3区医学 Q2 ORTHOPEDICS

Archives of Orthopaedic and Trauma Surgery Pub Date : 2025-05-24 DOI:10.1007/s00402-025-05932-7

Farouk Khury, Ittai Shichman, Sophia Antonioli, Joshua Rozell, Morteza Meftah, Ran Schwarzkopf

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引用次数: 0

Abstract

Background

Robotic assistance (RA) is increasingly used in total knee arthroplasty (TKA) for more accurate bony resection and balancing. However, the impact of robotic TKA (RATKA) on clinical outcomes and patient-reported measures (PROMs) remains unclear. This study aims to compare RATKA and conventional TKA (CTKA) using a novel robotic system.

Methods

A retrospective review was conducted on 10,031 patients who underwent TKA from February 2021 to October 2024. 289 RATKAs were performed with a hand-held robotic system. These RATKA cases were 1:1 propensity-score matched to CTKA for patient demographics, surgeon, implant system, and articulation design. Postoperative and clinical outcomes including surgical time, length of stay (LOS), discharge disposition, 90-day emergency department (ED) visits, manipulation under anesthesia (MUA), debridement, reoperations and revisions were collected and analyzed. Patient-reported outcomes measures (PROMs) included Knee Injury and Osteoarthritis Outcome Scores (KOOS, JR) and Patient Reported Outcome Measurement Information System (PROMIS) scores.

Results

RATKA demonstrated significantly shorter LOS (30.04 vs. 51.91 hours, p < 0.001, respectively) compared to CTKA. There was no difference in surgical time (107.18 vs. 106.22 minutes, p = 0.349). Although there was no statistical difference in 90-day ED visits, the majority of the CTKA revisits were due to surgery-related causes when compared to the RATKAs (1.38% vs. 0.34%, p = 0.239). While RATKAs had higher incidence of MUAs (2.07% vs. 0.34%, p = 0.201), CTKAs had more reoperations (1 vs. 0, p = 0.369) and more revisions than the RATKAs (6 vs. 0, p = 0.117). In terms of PROMs, both RATKAs and CTKAs showed similar improvements in KOOS, JR and PROMIS pain scores following TKA, with no significant differences in the magnitude of improvement at early postoperative timepoints. However, at the one-year follow-up, RATKA demonstrated significantly greater reduction in PROMIS pain intensity (Δ-9.12, p = 0.032) compared to CTKAs.

Conclusions

This retrospective analysis showed that the novel RATKA resulted in reduced length of stay, fewer reoperations, and greater reduction in one-year PROMIS pain intensity compared to CTKAs, despite having a higher incidence of MUA rates. Further research is needed to clarify these differences clinically and enhance patient outcomes.

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全膝关节置换术中新型机器人系统的临床和患者报告结果

机器人辅助（RA）越来越多地用于全膝关节置换术（TKA），以获得更准确的骨切除和平衡。然而，机器人TKA （RATKA）对临床结果和患者报告措施（PROMs）的影响尚不清楚。本研究的目的是比较RATKA和传统的TKA （CTKA）使用一个新的机器人系统。方法对2021年2月至2024年10月10031例TKA患者进行回顾性分析。289例ratka是用手持机器人系统进行的。这些RATKA病例在患者人口统计学、外科医生、种植体系统和关节设计方面与CTKA的倾向评分匹配为1:1。收集和分析术后和临床结果，包括手术时间、住院时间（LOS）、出院处置、90天急诊科（ED）就诊、麻醉下操作（MUA）、清创、再手术和翻修。患者报告的结果测量（PROMs）包括膝关节损伤和骨关节炎结果评分（oos， JR）和患者报告的结果测量信息系统（PROMIS）评分。结果与CTKA相比，ratka的LOS明显缩短（30.04小时vs 51.91小时，p < 0.001）。手术时间差异无统计学意义（107.18 vs 106.22 min, p = 0.349）。虽然90天ED就诊没有统计学差异，但与ratka相比，大多数CTKA就诊是由于手术相关原因（1.38% vs. 0.34%, p = 0.239）。虽然ratka的mua发生率较高（2.07% vs. 0.34%, p = 0.201），但ctka的再手术率（1 vs. 0, p = 0.369）和翻修率均高于ratka （6 vs. 0, p = 0.117）。在PROMs方面，ratka和ctka在TKA后的kos、JR和PROMIS疼痛评分中均显示出相似的改善，在术后早期时间点的改善程度无显著差异。然而，在一年的随访中，与ctka相比，RATKA显示出更显著的PROMIS疼痛强度降低（Δ-9.12, p = 0.032）。本回顾性分析显示，与ctka相比，新型RATKA缩短了住院时间，减少了再手术，并大大降低了一年期PROMIS疼痛强度，尽管MUA发生率较高。需要进一步的研究来澄清这些临床差异并提高患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Orthopaedic and Trauma Surgery 医学-外科

CiteScore

4.30

自引率

13.00%

发文量

424

审稿时长

2 months

期刊介绍： "Archives of Orthopaedic and Trauma Surgery" is a rich source of instruction and information for physicians in clinical practice and research in the extensive field of orthopaedics and traumatology. The journal publishes papers that deal with diseases and injuries of the musculoskeletal system from all fields and aspects of medicine. The journal is particularly interested in papers that satisfy the information needs of orthopaedic clinicians and practitioners. The journal places special emphasis on clinical relevance. "Archives of Orthopaedic and Trauma Surgery" is the official journal of the German Speaking Arthroscopy Association (AGA).