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

Gilmour, A., MacLean, A. D., Rowe, P. J., Banger, M. S., Donnelly, I., Jones, B. G. and Blyth, M. J.G. (2018) Robotic-arm–assisted vs conventional unicompartmental knee arthroplasty. The 2-year clinical outcomes of a randomized controlled trial. Journal of Arthroplasty, 33(7Suppl), S109-S115. (doi: 10.1016/j.arth.2018.02.050) (PMID:29627257)

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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.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Jones, Mr Bryn and Blyth, Mr Mark and Banger, Mr Matthew and Donnelly, Mrs Iona and Gilmour, Mr Alisdair
Authors: Gilmour, A., MacLean, A. D., Rowe, P. J., Banger, M. S., Donnelly, I., Jones, B. G., and Blyth, M. J.G.
College/School:College of Medical Veterinary and Life Sciences > School of Infection & Immunity
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Journal of Arthroplasty
Publisher:Elsevier
ISSN:0883-5403
ISSN (Online):1532-8406
Published Online:21 February 2018

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