Abstract
BackgroundTotal knee arthroplasty (TKA) is a successful treatment for tricompartmental knee arthritis. Computer navigation and robotic-assisted-surgery (RAS) have emerged as tools that aim to help plan and execute surgery with greater precision and consistency. We reviewed the most current literature to describe the historical background and outcomes compared to conventional TKA.MethodsA review and synthesis of the literature comparing the patient reported outcomes (PROM’s) of RA TKA and computer-assisted (CA) TKA to conventional TKA was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.ResultsCAS TKA improves accuracy and consistency of implant position, and appears to provide a small improvement in PROMs and implant survival compared to conventional TKA. RTKA similarly improves implant accuracy compared to conventional techniques and early results suggest a similar small benefit in PROMs compared to conventional TKA. A strengthening trend is emerging showing CAS TKA has greatest benefit to implant survival in people under 65. RTKA survival analysis data is more limited and early results do not allow strong conclusions, however early trends are similar to CAS TKA.ConclusionResults for CAS-TKA show improvement in alignment, and early clinical outcomes have revealed promising results, with longer-term data and medium-term survival analysis recently emerging showing small benefits over conventional TKA. RTKA represents another phase of development. Early results show similar trends to that of CAS TKA with longer-term data still to come.
Highlights
Total knee arthroplasty (TKA) is a successful treatment for tricompartmental knee arthritis
Accuracy of CAS TKA compared to conventional TKA Alignment and implant accuracy outcomes have received the most attention in the literature
The most important finding from our review was that CAS TKA improves accuracy and consistency of implant position, and appears to provide a small improvement in patient reported outcomes measures (PROMs) and implant survival compared to conventional TKA
Summary
Total knee arthroplasty (TKA) is a successful treatment for tricompartmental knee arthritis. Computer navigation and robotic-assisted-surgery (RAS) have emerged as tools that aim to help plan and execute surgery with greater precision and consistency, with the ultimate goal of improving patient outcomes in TKA. Emerging data on the use of this technology in unicompartmental knee replacement (UKR) suggests an improvement in outcomes and survival at 2 years (2.8 vs 4.6%) compared to conventional techniques [1, 2], with shortterm results showing similar outcomes for both CAS and robotically assisted UKR [3]. The purpose of this review is to describe the historical background of robotic and computer-navigated systems used most commonly for total knee replacements, and review the most current available literature regarding outcomes compared to conventional TKA. Computer navigation and robotic-assisted-surgery (RAS) have emerged as tools that aim to help plan and execute surgery with greater precision and consistency.
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