Robotic technology: current concepts, operative techniques and emerging uses in unicompartmental knee arthroplasty
- PMID: 32509336
- PMCID: PMC7265083
- DOI: 10.1302/2058-5241.5.190089
Robotic technology: current concepts, operative techniques and emerging uses in unicompartmental knee arthroplasty
Abstract
Unicompartmental knee arthroplasty (UKA) is associated with improved functional outcomes but reduced implant survivorship compared to total knee arthroplasty (TKA).Surgeon-controlled errors in component positioning are the most common reason for implant failure in UKA, and low UKA case-volume is associated with poor implant survivorship and earlier time to revision surgery.Robotic UKA is associated with improved accuracy of achieving the planned femoral and tibial component positioning compared to conventional manual UKA.Robotic UKA has a learning curve of six operative cases for achieving operative times and surgical team comfort levels comparable to conventional manual UKA, but there is no learning curve effect for accuracy of implant positioning or limb alignment.Robotic UKA is associated with reduced postoperative pain, decreased opiate analgesia requirements, faster inpatient rehabilitation, and earlier time to hospital discharge compared to conventional manual UKA.Limitations of robotic UKA include high installation costs, additional radiation exposure with image-based systems, and paucity of studies showing any long-term differences in functional outcomes or implant survivorship compared to conventional manual UKA.Further clinical studies are required to establish how statistical differences in accuracy of implant positioning between conventional manual UKA and robotic UKA translate to long-term differences in functional outcomes, implant survivorship, complications, and cost-effectiveness. Cite this article: EFORT Open Rev 2020;5:312-318. DOI: 10.1302/2058-5241.5.190089.
Keywords: functional outcomes; implant positioning; limb alignment; robotics; unicompartmental knee arthroplasty.
© 2020 The author(s).
Conflict of interest statement
ICMJE Conflict of interest statement: FSH reports board membership of the Bone and Joint Journal and The Annals of the Royal College of Surgeons; consultancy for Smith & Nephew, Corin, MatOrtho and Stryker; payment for lectures including service on speakers’ bureaus for Smith & Nephew and Stryker; royalties paid by Smith & Nephew, MatOrtho, Corin and Stryker, all outside the submitted work. The other authors declare no conflict of interest relevant to this work.
References
-
- Ackroyd CE. Medial compartment arthroplasty of the knee. J Bone Joint Surg Br 2003;85:937–942. - PubMed
-
- National Joint Registry for England, Wales, Northern Ireland and the Isle of Man. 16th Annual Report 2019. https://reports.njrcentre.org.uk/ (date last accessed 22 January 2020).
-
- Hamilton TW, Pandit HG, Maurer DG, et al. Anterior knee pain and evidence of osteoarthritis of the patellofemoral joint should not be considered contraindications to mobile-bearing unicompartmental knee arthroplasty: a 15-year follow-up. J Bone Joint Surg Br 2017. May;99-B:632–639. - PubMed
-
- Isaac SM, Barker KL, Danial IN, Beard DJ, Dodd CA, Murray DW. Does arthroplasty type influence knee joint proprioception? A longitudinal prospective study comparing total and unicompartmental arthroplasty. Knee 2007;14:212–217. - PubMed
-
- Liddle AD, Judge A, Pandit H, Murray DW. Adverse outcomes after total and unicompartmental knee replacement in 101,330 matched patients: a study of data from the National Joint Registry for England and Wales. Lancet 2014;384:1437–1445. - PubMed
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