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. 2021 Dec;141(12):2139-2146.
doi: 10.1007/s00402-021-04114-5. Epub 2021 Aug 18.

Robotics improves alignment accuracy and reduces early revision rates for UKA in the hands of low-volume UKA surgeons

Peter Savov  1 , Lars-Rene Tuecking  2 , Henning Windhagen  2 , Tilman Calliess  3 , Max Ettinger  2
Affiliations

Robotics improves alignment accuracy and reduces early revision rates for UKA in the hands of low-volume UKA surgeons

Peter Savov et al. Arch Orthop Trauma Surg. 2021 Dec.

Abstract

Purpose: It is known that in uni-compartmental knee arthroplasty (UKA) low-volume surgeons have a higher complication and revision rate than high-volume surgeons. Further, robotic-assisted UKA leads to lower early revision rate as well as fewer limb and joint line outliers compared to conventional UKA. The purpose of this study was to retrospectively analyze the outliers' and revision rate of low-volume UKA surgeons with different robotic systems at short-term follow-up.

Methods: In this case-control study, 103 robotic-assisted UKAs were included. The procedures were performed between 2016 and 2019 from two low-volume UKA surgeons with an imageless (IL) (63 patients) and image-based (IB) (40 patients) robotic system. Alignment outliers, joint line (JL) reconstruction, complication and revision rates of the two different robotic systems were analyzed. The minimum follow-up was two years. Outliers were defined as a postoperative valgus malalignment greater than 182°. The surgery time for all procedures was evaluated.

Results: The overall revision rate was 3.9% (4 of 103). Two occurred in the IB group (5.0%) and two in the IL group (3.2%). No valgus malalignment outliers were observed in both groups. The mean JL was not distalized by more than 2 mm in both groups (IL: 1.3 ± 1.6 mm vs. IB: 1.8 ± 0.9 mm, p value 0.08). The IL procedures had a significant lower mean surgery time (55 ± 13 min vs. 68 ± 14, p value 0.001).

Conclusion: Robotic-assisted UKA is a safe procedure in the hand of low-volume UKA surgeons. Robotic-assisted UKA minimizes overcorrection into valgus mal-alignment. Low revision rates are observed at short-term follow-up for robotic-assisted UKA. The choice of the different robotic systems has no impact on the outcome.

Keywords: Image-based; Imageless; Low volume; Robotic-assisted surgery; UKA.

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Conflict of interest statement

ME, TC and HW are educational consultants for Stryker. ME and PS are educational Consultants for Smith and Nephew.

Figures

Fig. 1
Fig. 1
Measurement of the joint line height with the method described by Henry et al.
See this image and copyright information in PMC

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