Robotic-arm-assisted vs conventional unicompartmental knee arthroplasty. The 2-year clinical outcomes of a randomized controlled trial

Alisdair Gilmour, Angus D. MacLean, Philip J. Rowe, Matthew S. Banger, Iona Donnelly, Bryn G. Jones, Mark J. G. Blyth

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: Unicompartmental knee arthroplasty (UKA) for treatment of medial compartment osteoarthritis has potential benefits over total knee arthroplasty but UKA has a higher revision rate. Robotic-assisted UKA is increasingly common and offers more accurate implant positioning and limb alignment, lower early postoperative pain but evidence of functional outcome is lacking. The aim was to assess the clinical outcomes of a single-centre, prospective, randomised controlled trial, comparing robotic-arm-assisted UKA with conventional surgery.
Methods: A total of 139 participants were recruited and underwent robotic-arm-assisted (fixed bearing) or conventional (mobile bearing) UKA. Fifty-eight patients in the robotic-arm-assisted group and 54 in the manual group at 2 years. The main outcome measures were the Oxford Knee Score, American Knee Society Score and revision rate.
Results: At 2 years, there were no significant differences for any of the outcome measures. Sub-group analysis (n = 35) of participants with a preoperative University of California Los Angeles Activity Scale >5 (more active) was performed. In this sub-group, the median Oxford Knee Score at 2 years was 46 (IQR 42.0-48.0) for robotic-arm-assisted and 41 (IQR 38.5-44.0) for the manual group (P = .036). The median American Knee Society Score was 193.5 (IQR 184.0-198.0) for the robotic-arm-assisted group and 174.0 (IQR 166.0-188.5) for the manual group (P = .017). Survivorship was 100% in robotic-arm-assisted group and 96.3% in the manual group.
Conclusion: Overall, participants achieved an outcome equivalent to the most widely implanted UKA in the United Kingdom. Sub-group analysis suggests that more active patients may benefit from robotic-arm-assisted surgery. Long term follow-up is required to evaluate differences in survivorship.
LanguageEnglish
Number of pages7
JournalJournal of Arthroplasty
Early online date21 Feb 2018
DOIs
Publication statusE-pub ahead of print - 21 Feb 2018

Fingerprint

Arthroplasty
Robotic arms
Knee Replacement Arthroplasties
Robotics
Arm
Randomized Controlled Trials
Bearings (structural)
Surgery
Knee
Survival Rate
Outcome Assessment (Health Care)
Los Angeles
Postoperative Pain
Osteoarthritis
Lower Extremity

Keywords

  • unicompartmental
  • UKA
  • knee
  • robotic
  • robotic-arm
  • RCT

Cite this

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title = "Robotic-arm-assisted vs conventional unicompartmental knee arthroplasty. The 2-year clinical outcomes of a randomized controlled trial",
abstract = "Background: Unicompartmental knee arthroplasty (UKA) for treatment of medial compartment osteoarthritis has potential benefits over total knee arthroplasty but UKA has a higher revision rate. Robotic-assisted UKA is increasingly common and offers more accurate implant positioning and limb alignment, lower early postoperative pain but evidence of functional outcome is lacking. The aim was to assess the clinical outcomes of a single-centre, prospective, randomised controlled trial, comparing robotic-arm-assisted UKA with conventional surgery.Methods: A total of 139 participants were recruited and underwent robotic-arm-assisted (fixed bearing) or conventional (mobile bearing) UKA. Fifty-eight patients in the robotic-arm-assisted group and 54 in the manual group at 2 years. The main outcome measures were the Oxford Knee Score, American Knee Society Score and revision rate.Results: At 2 years, there were no significant differences for any of the outcome measures. Sub-group analysis (n = 35) of participants with a preoperative University of California Los Angeles Activity Scale >5 (more active) was performed. In this sub-group, the median Oxford Knee Score at 2 years was 46 (IQR 42.0-48.0) for robotic-arm-assisted and 41 (IQR 38.5-44.0) for the manual group (P = .036). The median American Knee Society Score was 193.5 (IQR 184.0-198.0) for the robotic-arm-assisted group and 174.0 (IQR 166.0-188.5) for the manual group (P = .017). Survivorship was 100{\%} in robotic-arm-assisted group and 96.3{\%} in the manual group.Conclusion: Overall, participants achieved an outcome equivalent to the most widely implanted UKA in the United Kingdom. Sub-group analysis suggests that more active patients may benefit from robotic-arm-assisted surgery. Long term follow-up is required to evaluate differences in survivorship.",
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Robotic-arm-assisted vs conventional unicompartmental knee arthroplasty. The 2-year clinical outcomes of a randomized controlled trial. / Gilmour, Alisdair; MacLean, Angus D.; Rowe, Philip J.; Banger, Matthew S.; Donnelly, Iona; Jones, Bryn G.; Blyth, Mark J. G.

In: Journal of Arthroplasty, 21.02.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Robotic-arm-assisted vs conventional unicompartmental knee arthroplasty. The 2-year clinical outcomes of a randomized controlled trial

AU - Gilmour, Alisdair

AU - MacLean, Angus D.

AU - Rowe, Philip J.

AU - Banger, Matthew S.

AU - Donnelly, Iona

AU - Jones, Bryn G.

AU - Blyth, Mark J. G.

N1 - Copyright © 2018 Elsevier Inc. All rights reserved.

PY - 2018/2/21

Y1 - 2018/2/21

N2 - Background: Unicompartmental knee arthroplasty (UKA) for treatment of medial compartment osteoarthritis has potential benefits over total knee arthroplasty but UKA has a higher revision rate. Robotic-assisted UKA is increasingly common and offers more accurate implant positioning and limb alignment, lower early postoperative pain but evidence of functional outcome is lacking. The aim was to assess the clinical outcomes of a single-centre, prospective, randomised controlled trial, comparing robotic-arm-assisted UKA with conventional surgery.Methods: A total of 139 participants were recruited and underwent robotic-arm-assisted (fixed bearing) or conventional (mobile bearing) UKA. Fifty-eight patients in the robotic-arm-assisted group and 54 in the manual group at 2 years. The main outcome measures were the Oxford Knee Score, American Knee Society Score and revision rate.Results: At 2 years, there were no significant differences for any of the outcome measures. Sub-group analysis (n = 35) of participants with a preoperative University of California Los Angeles Activity Scale >5 (more active) was performed. In this sub-group, the median Oxford Knee Score at 2 years was 46 (IQR 42.0-48.0) for robotic-arm-assisted and 41 (IQR 38.5-44.0) for the manual group (P = .036). The median American Knee Society Score was 193.5 (IQR 184.0-198.0) for the robotic-arm-assisted group and 174.0 (IQR 166.0-188.5) for the manual group (P = .017). Survivorship was 100% in robotic-arm-assisted group and 96.3% in the manual group.Conclusion: Overall, participants achieved an outcome equivalent to the most widely implanted UKA in the United Kingdom. Sub-group analysis suggests that more active patients may benefit from robotic-arm-assisted surgery. Long term follow-up is required to evaluate differences in survivorship.

AB - Background: Unicompartmental knee arthroplasty (UKA) for treatment of medial compartment osteoarthritis has potential benefits over total knee arthroplasty but UKA has a higher revision rate. Robotic-assisted UKA is increasingly common and offers more accurate implant positioning and limb alignment, lower early postoperative pain but evidence of functional outcome is lacking. The aim was to assess the clinical outcomes of a single-centre, prospective, randomised controlled trial, comparing robotic-arm-assisted UKA with conventional surgery.Methods: A total of 139 participants were recruited and underwent robotic-arm-assisted (fixed bearing) or conventional (mobile bearing) UKA. Fifty-eight patients in the robotic-arm-assisted group and 54 in the manual group at 2 years. The main outcome measures were the Oxford Knee Score, American Knee Society Score and revision rate.Results: At 2 years, there were no significant differences for any of the outcome measures. Sub-group analysis (n = 35) of participants with a preoperative University of California Los Angeles Activity Scale >5 (more active) was performed. In this sub-group, the median Oxford Knee Score at 2 years was 46 (IQR 42.0-48.0) for robotic-arm-assisted and 41 (IQR 38.5-44.0) for the manual group (P = .036). The median American Knee Society Score was 193.5 (IQR 184.0-198.0) for the robotic-arm-assisted group and 174.0 (IQR 166.0-188.5) for the manual group (P = .017). Survivorship was 100% in robotic-arm-assisted group and 96.3% in the manual group.Conclusion: Overall, participants achieved an outcome equivalent to the most widely implanted UKA in the United Kingdom. Sub-group analysis suggests that more active patients may benefit from robotic-arm-assisted surgery. Long term follow-up is required to evaluate differences in survivorship.

KW - unicompartmental

KW - UKA

KW - knee

KW - robotic

KW - robotic-arm

KW - RCT

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DO - 10.1016/j.arth.2018.02.050

M3 - Article

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