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Robotic-arm assisted total knee arthroplasty is associated with comparable functional outcomes but improved forgotten joint scores compared with conventional manual total knee arthroplasty at five-year follow-up

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study reports the five-year functional outcomes from a prospective cohort study comparing robotic-arm assisted total knee arthroplasty (RO TKA) versus conventional manual total knee arthroplasty (CO TKA).

Methods

This prospective single-surgeon study included 120 patients with symptomatic end-stage knee arthritis undergoing primary TKA. This included 60 consecutive patients undergoing CO TKA followed by 60 consecutive patients undergoing RO TKA using a semi-automated robotic device. Study patients were reviewed at one, two, and five years after surgery and the following outcomes recorded: The University of California at Los Angeles activity-level (UCLA), Knee Society Score (KSS), Oxford Knee Score (OKS) Forgotten Joint Score (FJS), and any complications.

Results

There were no statistical differences between RO TKA and CO TKA in the median UCLA score (p = N.S), median KSS (p = N.S), and median OKS (p = N.S) at five-year follow-up. RO-TKA was associated with statistically significant improvements in the FJS at one (p = 0.001), two (p = 0.003), and five (p = 0.025) years of follow-up compared with CO TKA. There was no statistical difference in the incidence of knee stiffness requiring manipulation under anesthesia between the two treatment groups (p = N.S).

Conclusion

Patients in both treatment groups had excellent functional outcomes with comparable patient reported outcomes at five-year follow-up. RO TKA was associated with statistically significant improvements in the FJS compared with CO TKA, but these differences did not reach the minimal clinically important difference at any follow-up interval. There was no overall difference in complications between the two treatment groups at five-year follow-up.

Level of evidence

II (Prospective cohort study).

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Data availability

Study data can be provided on request.

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Acknowledgements

Nil.

Funding

No funding was received for this study.

Author information

Authors and Affiliations

  1. University College Hospital, 235 Euston Road, Bloomsbury, London, NW1 2BU, UK

    Babar Kayani, Andreas Fontalis, Isabella Catrina Haddad, Christian Donovan, Vishal Rajput & Fares Sami Haddad

  2. Princess Grace Hospital, 42-52 Nottingham Place, Marylebone, London, W1U 5NY, UK

    Vishal Rajput & Fares Sami Haddad

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  1. Babar Kayani
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  2. Andreas Fontalis
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Contributions

BK, AF, ICH, and CD collected all the data wrote the manuscript. VR edited the manuscript and performed the statistical analysis. FSH edited the manuscript,

Corresponding author

Correspondence to Babar Kayani.

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Conflict of interest

The senior author (FSH) receives intellectual property royalties and is a paid consultant for Smith & Nephew Ltd and Stryker Ltd. The remaining authors have no conflicts of interest to declare.

Ethical approval

Hospital review board approval was obtained prior to the commencement of the study.

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Informed consent was obtained from all study participants.

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Kayani, B., Fontalis, A., Haddad, I.C. et al. Robotic-arm assisted total knee arthroplasty is associated with comparable functional outcomes but improved forgotten joint scores compared with conventional manual total knee arthroplasty at five-year follow-up. Knee Surg Sports Traumatol Arthrosc 31, 5453–5462 (2023). https://doi.org/10.1007/s00167-023-07578-7

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