Fabio Mancino1,2,3, Stefano Marco Paolo Rossi4, Rudy Sangaletti1, Ludovico Lucenti1, Flavio Terragnoli5, Francesco Benazzo1,6. 1. Sezione di Chirurgia Protesica ad Indirizzo Robotico - Unità di Traumatologia dello Sport, U.O.C Ortopedia e Traumatologia, Fondazione Poliambulanza, Via Bissolati 57, 25124, Brescia, Italy. 2. Unità di Ortopedia e Traumatologia, Dipartimento di Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy. 3. Università Cattolica del Sacro Cuore, Rome, Italy. 4. Sezione di Chirurgia Protesica ad Indirizzo Robotico - Unità di Traumatologia dello Sport, U.O.C Ortopedia e Traumatologia, Fondazione Poliambulanza, Via Bissolati 57, 25124, Brescia, Italy. rossi.smp@gmail.com. 5. U.O.C. Ortopedia e Traumatologia, Fondazione Poliambulanza, Via Bissolati 57, Brescia, Italy. 6. IUSS Istituto Universitario di Studi Superiori, Pavia, Italy.
Abstract
BACKGROUND: Robotic assisted total knee arthroplasty (RTKA) has shown improved knee alignment and reduced radiographic outliers. However, there remains debate on functional outcomes and patient-reported outcomes (PROMs). This study compares the 1-year clinical outcomes of a new imageless robotically assisted technique (ROSA Knee System, Zimmer Biomet, Warsaw, IN) with an imageless navigated procedure (NTKA, iAssist Knee, Zimmer, Warsaw, IN). METHODS: The study is a retrospective analysis of prospectively collected data that compared the functional outcomes and PROMs of 50 imageless RTKA with 47 imageless NTKA at 1-year follow-up. Baseline characteristics, intraoperative and postoperative information were collected including complications, revisions, Knee Society Score (KSS), Knee injury and Osteoarthritis Outcome Score (KOOS) score, and Forgotten Joint Score (FJS-12). Radiographic analysis of preoperative and postoperative images evaluating hip-knee-ankle (HKA) angle was performed. RESULTS: There was no difference regarding baseline characteristics between the groups. Mean operative time was significantly longer in the RTKA group (122 min vs. 97 min; p < 0.0001). Significant differences were reported for the "Pain" (85 [RTKA] vs 79.1 [NTKA]; p = 0.0283) subsection of the KOOS score. In addition, RTKA was associated with higher maximum range of motion (119.4° vs. 107.1°; p < 0.0001) and better mean improvement of the arc of motion by 11.67° (23.02° vs. 11.36°; p < 0.0001). No significant differences were noted for other subsections of KOOS, KSS, FJS-12, complications, or limb alignment at 1-year follow-up. CONCLUSIONS: Imageless RTKA was associated with longer surgical time, better pain perception and improved ROM at 12-month follow-up compared with NTKA. No significant differences were reported on other PROMs, complication rates and radiographic outcomes. LEVEL OF EVIDENCE: III.
BACKGROUND: Robotic assisted total knee arthroplasty (RTKA) has shown improved knee alignment and reduced radiographic outliers. However, there remains debate on functional outcomes and patient-reported outcomes (PROMs). This study compares the 1-year clinical outcomes of a new imageless robotically assisted technique (ROSA Knee System, Zimmer Biomet, Warsaw, IN) with an imageless navigated procedure (NTKA, iAssist Knee, Zimmer, Warsaw, IN). METHODS: The study is a retrospective analysis of prospectively collected data that compared the functional outcomes and PROMs of 50 imageless RTKA with 47 imageless NTKA at 1-year follow-up. Baseline characteristics, intraoperative and postoperative information were collected including complications, revisions, Knee Society Score (KSS), Knee injury and Osteoarthritis Outcome Score (KOOS) score, and Forgotten Joint Score (FJS-12). Radiographic analysis of preoperative and postoperative images evaluating hip-knee-ankle (HKA) angle was performed. RESULTS: There was no difference regarding baseline characteristics between the groups. Mean operative time was significantly longer in the RTKA group (122 min vs. 97 min; p < 0.0001). Significant differences were reported for the "Pain" (85 [RTKA] vs 79.1 [NTKA]; p = 0.0283) subsection of the KOOS score. In addition, RTKA was associated with higher maximum range of motion (119.4° vs. 107.1°; p < 0.0001) and better mean improvement of the arc of motion by 11.67° (23.02° vs. 11.36°; p < 0.0001). No significant differences were noted for other subsections of KOOS, KSS, FJS-12, complications, or limb alignment at 1-year follow-up. CONCLUSIONS: Imageless RTKA was associated with longer surgical time, better pain perception and improved ROM at 12-month follow-up compared with NTKA. No significant differences were reported on other PROMs, complication rates and radiographic outcomes. LEVEL OF EVIDENCE: III.
Authors: Sébastien Parratte; Andrew J Price; Lee M Jeys; William F Jackson; Henry D Clarke Journal: J Arthroplasty Date: 2019-06-26 Impact factor: 4.757
Authors: Rajitha Gunaratne; Dylan N Pratt; Joseph Banda; Daniel P Fick; Riaz J K Khan; Brett W Robertson Journal: J Arthroplasty Date: 2017-07-21 Impact factor: 4.757
Authors: Robert C Marchand; Nipun Sodhi; Anton Khlopas; Assem A Sultan; Steven F Harwin; Arthur L Malkani; Michael A Mont Journal: J Knee Surg Date: 2017-10-13 Impact factor: 2.757
Authors: Emily L Hampp; Morad Chughtai; Laura Y Scholl; Nipun Sodhi; Manoshi Bhowmik-Stoker; David J Jacofsky; Michael A Mont Journal: J Knee Surg Date: 2018-05-01 Impact factor: 2.757
Authors: Anton Khlopas; Nipun Sodhi; William J Hozack; Antonia F Chen; Ormonde M Mahoney; Tracy Kinsey; Fabio Orozco; Michael A Mont Journal: J Knee Surg Date: 2019-04-08 Impact factor: 2.757
Authors: Robert B Bourne; Bert M Chesworth; Aileen M Davis; Nizar N Mahomed; Kory D J Charron Journal: Clin Orthop Relat Res Date: 2010-01 Impact factor: 4.176